How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $173.78 Median $2,511.89 Typical High $7,943.28 | Facility | None | $173.78 | $2,511.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $245.47 | Professional | None | $104.71 | $162.18 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | None | $123.03 | $123.03 | $131.83 |
BCBS Setting Facility Modifier None Typical Low $128.82 Median $478.63 Typical High $501.19 | Facility | None | $128.82 | $478.63 | $501.19 |
BCBS Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $257.04 | Professional | None | $190.55 | $190.55 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $138.04 Typical High $389.05 | Facility | None | $120.23 | $138.04 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $309.03 | Professional | None | $109.65 | $162.18 | $309.03 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $380.19 Typical High $11,481.54 | Facility | None | $158.49 | $380.19 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $1,202.26 | Professional | None | $158.49 | $218.78 | $1,202.26 |
United Setting Facility Modifier None Typical Low $125.89 Median $407.38 Typical High $1,778.28 | Facility | None | $125.89 | $407.38 | $1,778.28 |
United Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $239.88 | Professional | None | $104.71 | $158.49 | $239.88 |
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 $52.48 Median $79.43 Typical High $123.03 | Professional | 52 · Reduced service | $52.48 | $79.43 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $31.62 Typical High $48.98 | Professional | 53 · Discontinued | $20.89 | $31.62 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $120.23 Typical High $186.21 | Professional | 54 · Surgery only | $79.43 | $120.23 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $23.99 Typical High $37.15 | Professional | 55 · Aftercare only | $15.85 | $23.99 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.85 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.47 | $15.85 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $112.20 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $74.13 | $112.20 | $173.78 |
Where Kansas sits
The same service costs 3.2 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.
Kansas· 7th of 51
$240
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.