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 $288.40 Median $2,691.53 Typical High $7,943.28 | Facility | None | $288.40 | $2,691.53 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $346.74 | Professional | None | $125.89 | $223.87 | $346.74 |
BCBS Kansas Setting Facility Modifier None Typical Low $229.09 Median $501.19 Typical High $537.03 | Facility | None | $229.09 | $501.19 | $537.03 |
BCBS Kansas Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $338.84 | Professional | None | $213.80 | $213.80 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $245.47 Typical High $257.04 | Facility | None | $177.83 | $245.47 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $354.81 | Professional | None | $162.18 | $257.04 | $354.81 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,380.38 | Facility | None | $54.95 | $331.13 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $1,949.84 | Professional | None | $234.42 | $288.40 | $1,949.84 |
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 $151.36 Median $245.47 Typical High $346.74 | Professional | None | $151.36 | $245.47 | $346.74 |
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 $63.10 Median $100.00 Typical High $173.78 | Professional | 52 · Reduced service | $63.10 | $100.00 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $39.81 Typical High $70.79 | Professional | 53 · Discontinued | $25.12 | $39.81 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $147.91 Typical High $263.03 | Professional | 54 · Surgery only | $95.50 | $147.91 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $29.51 Typical High $52.48 | Professional | 55 · Aftercare only | $19.05 | $29.51 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.95 Typical High $34.67 | Professional | 56 · Pre-op care only | $12.59 | $19.95 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $138.04 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $89.13 | $138.04 | $245.47 |
Where Kansas sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 17th of 51
$275
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.