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 $380.19 Median $457.09 Typical High $676.08 | Professional | None | $380.19 | $457.09 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
HMSA Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $676.08 | Professional | None | $524.81 | $616.60 | $676.08 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $309.03 Typical High $338.84 | Professional | 51 · Multiple procedures | $263.03 | $309.03 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $602.56 | Professional | None | $407.38 | $489.78 | $602.56 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,737.80 | Facility | None | $1,202.26 | $1,380.38 | $1,737.80 |
United Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | None | $524.81 | $524.81 | $537.03 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $407.38 Typical High $575.44 | Professional | None | $29.51 | $407.38 | $575.44 |
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 $190.55 Median $229.09 Typical High $338.84 | Professional | 52 · Reduced service | $190.55 | $229.09 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $91.20 Typical High $134.90 | Professional | 53 · Discontinued | $75.86 | $91.20 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $338.84 Typical High $501.19 | Professional | 54 · Surgery only | $288.40 | $338.84 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $100.00 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $45.71 Typical High $67.61 | Professional | 56 · Pre-op care only | $38.02 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $316.23 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $269.15 | $316.23 | $467.74 |
Where Hawaii sits
The same service costs 5.5 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· 28th of 51
$525
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.