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 $309.03 Median $4,677.35 Typical High $9,549.93 | Facility | None | $309.03 | $4,677.35 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $309.03 | Professional | None | $117.49 | $194.98 | $309.03 |
BCBS Kansas Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $331.13 | Professional | None | $186.21 | $186.21 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $57.54 | Facility | None | $52.48 | $52.48 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $338.84 | Professional | None | $138.04 | $245.47 | $338.84 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $316.23 Typical High $1,348.96 | Facility | None | $54.95 | $316.23 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $1,698.24 | Professional | None | $234.42 | $275.42 | $1,698.24 |
United Setting Facility Modifier None Typical Low $125.89 Median $398.11 Typical High $1,778.28 | Facility | None | $125.89 | $398.11 | $1,778.28 |
United Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $316.23 | Professional | None | $138.04 | $234.42 | $316.23 |
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 $58.88 Median $93.33 Typical High $151.36 | Professional | 52 · Reduced service | $58.88 | $93.33 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $37.15 Typical High $61.66 | Professional | 53 · Discontinued | $23.44 | $37.15 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $138.04 Typical High $229.09 | Professional | 54 · Surgery only | $87.10 | $138.04 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $27.54 Typical High $45.71 | Professional | 55 · Aftercare only | $17.78 | $27.54 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $18.62 Typical High $30.90 | Professional | 56 · Pre-op care only | $11.75 | $18.62 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $128.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $81.28 | $128.82 | $213.80 |
Where Kansas sits
The same service costs 3.8 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· 18th of 51
$245
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.