How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,445 to $9,772Professionalmedian $1,072 · 10th to 90th $794 to $5,754
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 $2,041.74 Median $5,128.61 Typical High $9,549.93 | Facility | None | $2,041.74 | $5,128.61 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,230.27 | Professional | None | $794.33 | $977.24 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $1,148.15 | Professional | None | $154.88 | $154.88 | $1,148.15 |
BCBS Kansas Setting Facility Modifier None Typical Low $3,981.07 Median $5,888.44 Typical High $6,165.95 | Facility | None | $3,981.07 | $5,888.44 | $6,165.95 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $6,309.57 Typical High $6,456.54 | Facility | None | $912.01 | $6,309.57 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,174.90 | Professional | None | $851.14 | $1,096.48 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $3,981.07 Typical High $26,302.68 | Facility | None | $977.24 | $3,981.07 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $5,754.40 | Professional | None | $776.25 | $1,023.29 | $5,754.40 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,302.69 | Facility | None | $933.25 | $3,548.13 | $12,302.69 |
United Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,258.93 | Professional | None | $741.31 | $912.01 | $1,258.93 |
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 $398.11 Median $489.78 Typical High $616.60 | Professional | 52 · Reduced service | $398.11 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $199.53 Typical High $245.47 | Professional | 53 · Discontinued | $158.49 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $741.31 Typical High $912.01 | Professional | 54 · Surgery only | $588.84 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $147.91 Typical High $181.97 | Professional | 55 · Aftercare only | $120.23 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $97.72 Typical High $123.03 | Professional | 56 · Pre-op care only | $79.43 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $691.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $549.54 | $691.83 | $851.14 |
Where Kansas sits
The same service costs 5.7 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $14,279MT $2,518
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.