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 $724.44 Median $3,630.78 Typical High $7,943.28 | Facility | None | $724.44 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $660.69 | Professional | None | $288.40 | $457.09 | $660.69 |
BCBS Kansas Setting Facility Modifier None Typical Low $316.23 Median $338.84 Typical High $338.84 | Facility | None | $316.23 | $338.84 | $338.84 |
BCBS Kansas Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $602.56 | Professional | None | $407.38 | $407.38 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $933.25 Typical High $933.25 | Facility | None | $331.13 | $933.25 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $630.96 | Professional | None | $302.00 | $501.19 | $630.96 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $1,348.96 Typical High $11,481.54 | Facility | None | $512.86 | $1,348.96 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $2,137.96 Typical High $3,235.94 | Professional | None | $446.68 | $2,137.96 | $3,235.94 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,737.80 Typical High $4,570.88 | Facility | None | $831.76 | $1,737.80 | $4,570.88 |
United Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $630.96 | Professional | None | $331.13 | $436.52 | $630.96 |
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 $144.54 Median $229.09 Typical High $331.13 | Professional | 52 · Reduced service | $144.54 | $229.09 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $91.20 Typical High $131.83 | Professional | 53 · Discontinued | $57.54 | $91.20 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $338.84 Typical High $501.19 | Professional | 54 · Surgery only | $218.78 | $338.84 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $67.61 Typical High $100.00 | Professional | 55 · Aftercare only | $43.65 | $67.61 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $45.71 Typical High $66.07 | Professional | 56 · Pre-op care only | $28.84 | $45.71 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $316.23 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $204.17 | $316.23 | $467.74 |
Where Kansas sits
The same service costs 4.7 times more in Alaska than in Utah. 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· 17th of 51
$513
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.