How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,445 to $9,550Professionalmedian $1,259 · 10th to 90th $871 to $6,457
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 $1,698.24 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,698.24 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,348.96 | Professional | None | $870.96 | $1,096.48 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
BCBS Kansas Setting Facility Modifier None Typical Low $5,495.41 Median $8,511.38 Typical High $8,912.51 | Facility | None | $5,495.41 | $8,511.38 | $8,912.51 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,309.57 Typical High $6,606.93 | Facility | None | $645.65 | $6,309.57 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $1,348.96 | Professional | None | $933.25 | $1,348.96 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $3,715.35 Typical High $26,302.68 | Facility | None | $1,023.29 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $6,456.54 | Professional | None | $933.25 | $1,174.90 | $6,456.54 |
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 $870.96 Median $1,023.29 Typical High $1,445.44 | Professional | None | $870.96 | $1,023.29 | $1,445.44 |
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 $436.52 Median $549.54 Typical High $676.08 | Professional | 52 · Reduced service | $436.52 | $549.54 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $218.78 Typical High $269.15 | Professional | 53 · Discontinued | $173.78 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $812.83 Typical High $1,023.29 | Professional | 54 · Surgery only | $660.69 | $812.83 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $162.18 Typical High $204.17 | Professional | 55 · Aftercare only | $131.83 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $109.65 Typical High $134.90 | Professional | 56 · Pre-op care only | $87.10 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $758.58 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $616.60 | $758.58 | $954.99 |
Where Kansas sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.