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 $1,318.26 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,318.26 | $2,238.72 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $2,951.21 Typical High $6,165.95 | Professional | None | $524.81 | $2,951.21 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,737.80 | $2,089.30 | $2,570.40 |
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 $2,187.76 Median $4,168.69 Typical High $4,168.69 | Professional | None | $2,187.76 | $4,168.69 | $4,168.69 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
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 $660.69 Median $1,122.02 Typical High $1,621.81 | Professional | 52 · Reduced service | $660.69 | $1,122.02 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $457.09 Typical High $660.69 | Professional | 53 · Discontinued | $263.03 | $457.09 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,698.24 Typical High $2,454.71 | Professional | 54 · Surgery only | $977.24 | $1,698.24 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $338.84 Typical High $489.78 | Professional | 55 · Aftercare only | $194.98 | $338.84 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $223.87 Typical High $331.13 | Professional | 56 · Pre-op care only | $131.83 | $223.87 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,584.89 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $912.01 | $1,584.89 | $2,290.87 |
Where Hawaii sits
The same service costs 18.2 times more in Alaska than in New York. 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· 41st of 51
$2,089
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.