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 $91.20 Median $141.25 Typical High $194.98 | Professional | None | $91.20 | $141.25 | $194.98 |
BCBS Kansas Setting Facility Modifier None Typical Low $93.33 Median $263.03 Typical High $281.84 | Facility | None | $93.33 | $263.03 | $281.84 |
BCBS Kansas Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $204.17 | Professional | None | $165.96 | $165.96 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $794.33 Typical High $1,047.13 | Facility | None | $77.62 | $794.33 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $208.93 | Professional | None | $91.20 | $141.25 | $208.93 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $562.34 Typical High $2,630.27 | Facility | None | $54.95 | $562.34 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $676.08 Typical High $1,445.44 | Professional | None | $128.82 | $676.08 | $1,445.44 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,047.13 Typical High $3,311.31 | Facility | None | $501.19 | $1,047.13 | $3,311.31 |
United Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $181.97 | Professional | None | $100.00 | $128.82 | $181.97 |
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 $45.71 Median $70.79 Typical High $97.72 | Professional | 52 · Reduced service | $45.71 | $70.79 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $28.18 Typical High $38.90 | Professional | 53 · Discontinued | $18.20 | $28.18 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $107.15 Typical High $144.54 | Professional | 54 · Surgery only | $67.61 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $21.38 Typical High $28.84 | Professional | 55 · Aftercare only | $13.49 | $21.38 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.13 Typical High $19.50 | Professional | 56 · Pre-op care only | $9.12 | $14.13 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $100.00 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $63.10 | $100.00 | $134.90 |
Where Kansas sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 13th of 51
$166
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.