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 $954.99 Median $3,162.28 Typical High $7,943.28 | Facility | None | $954.99 | $3,162.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $97.72 Typical High $134.90 | Professional | None | $61.66 | $97.72 | $134.90 |
BCBS Setting Facility Modifier None Typical Low $70.79 Median $74.13 Typical High $74.13 | Facility | None | $70.79 | $74.13 | $74.13 |
BCBS Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $67.61 Typical High $67.61 | Facility | None | $66.07 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $141.25 | Professional | None | $72.44 | $95.50 | $141.25 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $186.21 Typical High $1,288.25 | Facility | None | $54.95 | $186.21 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $741.31 | Professional | None | $95.50 | $114.82 | $741.31 |
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 $70.79 Median $97.72 Typical High $144.54 | Professional | None | $70.79 | $97.72 | $144.54 |
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 $30.90 Median $47.86 Typical High $67.61 | Professional | 52 · Reduced service | $30.90 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $19.50 Typical High $26.92 | Professional | 53 · Discontinued | $12.30 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $72.44 Typical High $100.00 | Professional | 54 · Surgery only | $45.71 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $14.45 Typical High $19.95 | Professional | 55 · Aftercare only | $9.12 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $9.77 Typical High $13.49 | Professional | 56 · Pre-op care only | $6.17 | $9.77 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $67.61 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $42.66 | $67.61 | $93.33 |
Where Kansas sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 27th of 51
$100
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.