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 $812.83 Median $1,122.02 Typical High $1,380.38 | Professional | None | $812.83 | $1,122.02 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,380.38 | $1,698.24 |
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 $1,479.11 Median $1,479.11 Typical High $1,513.56 | Professional | None | $1,479.11 | $1,479.11 | $1,513.56 |
University Health Alliance Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
4 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 54 · Surgery only Typical Low $602.56 Median $831.76 Typical High $1,023.29 | Professional | 54 · Surgery only | $602.56 | $831.76 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $165.96 Typical High $204.17 | Professional | 55 · Aftercare only | $120.23 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $112.20 Typical High $138.04 | Professional | 56 · Pre-op care only | $81.28 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $776.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $562.34 | $776.25 | $954.99 |
Where Hawaii sits
The same service costs 16.2 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· 17th of 51
$1,479
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.