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 $1,949.84 Median $5,495.41 Typical High $5,495.41 | Facility | None | $1,949.84 | $5,495.41 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,202.26 | Professional | None | $691.83 | $776.25 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,071.52 | Professional | None | $724.44 | $851.14 | $1,071.52 |
United Setting Facility Modifier None Typical Low $2,238.72 Median $3,019.95 Typical High $3,890.45 | Facility | None | $2,238.72 | $3,019.95 | $3,890.45 |
United Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $954.99 | Professional | None | $933.25 | $933.25 | $954.99 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $912.01 Typical High $1,023.29 | Professional | None | $29.51 | $912.01 | $1,023.29 |
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 $338.84 Median $380.19 Typical High $588.84 | Professional | 52 · Reduced service | $338.84 | $380.19 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $234.42 | Professional | 53 · Discontinued | $138.04 | $154.88 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $891.25 | Professional | 54 · Surgery only | $512.86 | $575.44 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $177.83 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $117.49 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $831.76 |
Where Hawaii sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 30th of 51
$933
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.