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 $1,412.54 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,621.81 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
HMSA Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,454.71 | Professional | None | $1,905.46 | $2,238.72 | $2,454.71 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $954.99 Median $1,122.02 Typical High $1,230.27 | Professional | 51 · Multiple procedures | $954.99 | $1,122.02 | $1,230.27 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $380.19 Typical High $416.87 | Professional | AS · PA/NP assist | $323.59 | $380.19 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,445.44 | $1,737.80 | $2,187.76 |
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 $1,905.46 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,905.46 | $1,905.46 | $1,995.26 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $1,380.38 Typical High $2,089.30 | Professional | None | $29.51 | $1,380.38 | $2,089.30 |
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 $707.95 Median $794.33 Typical High $1,230.27 | Professional | 52 · Reduced service | $707.95 | $794.33 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $489.78 | Professional | 53 · Discontinued | $281.84 | $316.23 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $239.88 Typical High $371.54 | Professional | 55 · Aftercare only | $213.80 | $239.88 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $158.49 Typical High $245.47 | Professional | 56 · Pre-op care only | $141.25 | $158.49 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,122.02 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,122.02 | $1,698.24 |
Where Hawaii sits
The same service costs 5.6 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· 30th of 51
$1,905
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.