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 $724.44 Median $831.76 Typical High $1,202.26 | Professional | None | $724.44 | $831.76 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
HMSA Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,174.90 | $1,288.25 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $588.84 Typical High $645.65 | Professional | 51 · Multiple procedures | $501.19 | $588.84 | $645.65 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $199.53 Typical High $218.78 | Professional | AS · PA/NP assist | $169.82 | $199.53 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,202.26 | Professional | None | $794.33 | $954.99 | $1,202.26 |
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $741.31 Typical High $1,096.48 | Professional | None | $29.51 | $741.31 | $1,096.48 |
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 $363.08 Median $407.38 Typical High $616.60 | Professional | 52 · Reduced service | $363.08 | $407.38 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $251.19 | Professional | 53 · Discontinued | $144.54 | $162.18 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $933.25 | Professional | 54 · Surgery only | $549.54 | $616.60 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $186.21 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $123.03 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $870.96 |
Where Hawaii sits
The same service costs 5.8 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· 26th of 51
$1,023
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.