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 $537.03 Median $616.60 Typical High $912.01 | Professional | None | $537.03 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $2,951.21 Median $3,235.94 Typical High $4,677.35 | Facility | None | $2,951.21 | $3,235.94 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $870.96 | Professional | None | $575.44 | $691.83 | $870.96 |
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 $741.31 Median $741.31 Typical High $758.58 | Professional | None | $741.31 | $741.31 | $758.58 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $724.44 Typical High $812.83 | Professional | None | $29.51 | $724.44 | $812.83 |
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 $269.15 Median $302.00 Typical High $467.74 | Professional | 52 · Reduced service | $269.15 | $302.00 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $120.23 Typical High $186.21 | Professional | 53 · Discontinued | $107.15 | $120.23 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $457.09 Typical High $691.83 | Professional | 54 · Surgery only | $407.38 | $457.09 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $91.20 Typical High $138.04 | Professional | 55 · Aftercare only | $81.28 | $91.20 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $60.26 Typical High $93.33 | Professional | 56 · Pre-op care only | $53.70 | $60.26 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $426.58 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $380.19 | $426.58 | $645.65 |
Where Hawaii sits
The same service costs 5.9 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· 31st of 51
$741
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.