How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $3,890.45 | Professional | None | $2,290.87 | $2,570.40 | $3,890.45 |
HMSA Setting Professional Modifier None Typical Low $3,162.28 Median $3,715.35 Typical High $4,073.80 | Professional | None | $3,162.28 | $3,715.35 | $4,073.80 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $1,584.89 Median $1,862.09 Typical High $2,041.74 | Professional | 51 · Multiple procedures | $1,584.89 | $1,862.09 | $2,041.74 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $537.03 Median $630.96 Typical High $691.83 | Professional | AS · PA/NP assist | $537.03 | $630.96 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,570.40 Median $3,090.30 Typical High $3,801.89 | Professional | None | $2,570.40 | $3,090.30 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $2,511.89 | Facility | None | $1,148.15 | $1,202.26 | $2,511.89 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,311.31 | Professional | None | $3,235.94 | $3,235.94 | $3,311.31 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $2,238.72 Typical High $3,467.37 | Professional | None | $29.51 | $2,238.72 | $3,467.37 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,288.25 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,148.15 | $1,288.25 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $512.86 Typical High $776.25 | Professional | 53 · Discontinued | $457.09 | $512.86 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,949.84 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,737.80 | $1,949.84 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $389.05 Typical High $588.84 | Professional | 55 · Aftercare only | $346.74 | $389.05 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $257.04 Typical High $389.05 | Professional | 56 · Pre-op care only | $229.09 | $257.04 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,819.70 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,819.70 | $2,754.23 |
Where Hawaii sits
The same service costs 26.9 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Hawaii· 24th of 51
$3,388
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.