How much rates vary
Facilitymedian $3,090 · 10th to 90th $955 to $5,623Professionalmedian $708 · 10th to 90th $479 to $4,467
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 $1,000.00 Median $3,630.78 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $741.31 | Professional | None | $457.09 | $602.56 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
BCBS Kansas Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,235.94 | Facility | None | $3,090.30 | $3,090.30 | $3,235.94 |
BCBS Kansas Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $4,466.84 Typical High $5,011.87 | Facility | None | $524.81 | $4,466.84 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $776.25 | Professional | None | $512.86 | $776.25 | $776.25 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $16,218.10 | Facility | None | $691.83 | $1,737.80 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $4,466.84 | Professional | None | $537.03 | $676.08 | $4,466.84 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,737.80 Typical High $4,677.35 | Facility | None | $831.76 | $1,737.80 | $4,677.35 |
United Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $812.83 | Professional | None | $478.63 | $549.54 | $812.83 |
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 $239.88 Median $302.00 Typical High $371.54 | Professional | 52 · Reduced service | $239.88 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $120.23 Typical High $147.91 | Professional | 53 · Discontinued | $95.50 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $457.09 Typical High $562.34 | Professional | 54 · Surgery only | $363.08 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $91.20 Typical High $112.20 | Professional | 55 · Aftercare only | $72.44 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $60.26 Typical High $74.13 | Professional | 56 · Pre-op care only | $47.86 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $426.58 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $338.84 | $426.58 | $524.81 |
Where Kansas sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.