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 $218.78 Median $3,630.78 Typical High $8,912.51 | Facility | None | $218.78 | $3,630.78 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $257.04 Typical High $512.86 | Professional | None | $141.25 | $257.04 | $512.86 |
BCBS Kansas Setting Facility Modifier None Typical Low $128.82 Median $302.00 Typical High $323.59 | Facility | None | $128.82 | $302.00 | $323.59 |
BCBS Kansas Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $354.81 | Professional | None | $177.83 | $177.83 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $138.04 Typical High $151.36 | Facility | None | $104.71 | $138.04 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $288.40 Typical High $467.74 | Professional | None | $144.54 | $288.40 | $467.74 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $338.84 Typical High $1,380.38 | Facility | None | $54.95 | $338.84 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $1,288.25 Typical High $2,570.40 | Professional | None | $302.00 | $1,288.25 | $2,570.40 |
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 $141.25 Median $269.15 Typical High $398.11 | Professional | None | $141.25 | $269.15 | $398.11 |
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 $70.79 Median $112.20 Typical High $257.04 | Professional | 52 · Reduced service | $70.79 | $112.20 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $44.67 Typical High $102.33 | Professional | 53 · Discontinued | $28.18 | $44.67 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $165.96 Typical High $380.19 | Professional | 54 · Surgery only | $107.15 | $165.96 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $33.88 Typical High $75.86 | Professional | 55 · Aftercare only | $21.38 | $33.88 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $22.39 Typical High $51.29 | Professional | 56 · Pre-op care only | $14.13 | $22.39 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $154.88 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $100.00 | $154.88 | $354.81 |
Where Kansas sits
The same service costs 3.6 times more in Wisconsin 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· 14th of 51
$324
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.