How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,585 to $9,772Professionalmedian $1,585 · 10th to 90th $1,096 to $7,943
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 $1,659.59 Median $4,786.30 Typical High $8,912.51 | Facility | None | $1,659.59 | $4,786.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,071.52 | $1,348.96 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $977.24 Typical High $1,230.27 | Professional | None | $120.23 | $977.24 | $1,230.27 |
BCBS Kansas Setting Facility Modifier None Typical Low $4,570.88 Median $8,511.38 Typical High $8,912.51 | Facility | None | $4,570.88 | $8,511.38 | $8,912.51 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $4,897.79 Typical High $5,128.61 | Facility | None | $912.01 | $4,897.79 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,698.24 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $4,168.69 Typical High $26,302.68 | Facility | None | $1,071.52 | $4,168.69 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $7,943.28 | Professional | None | $1,174.90 | $1,445.44 | $7,943.28 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,715.35 Typical High $12,302.69 | Facility | None | $933.25 | $3,715.35 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,258.93 | $1,819.70 |
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 $537.03 Median $676.08 Typical High $831.76 | Professional | 52 · Reduced service | $537.03 | $676.08 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $269.15 Typical High $331.13 | Professional | 53 · Discontinued | $213.80 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,000.00 Typical High $1,230.27 | Professional | 54 · Surgery only | $812.83 | $1,000.00 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $199.53 Typical High $251.19 | Professional | 55 · Aftercare only | $162.18 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $134.90 Typical High $165.96 | Professional | 56 · Pre-op care only | $107.15 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $933.25 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $758.58 | $933.25 | $1,148.15 |
Where Kansas sits
The same service costs 4.2 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 $14,362MT $3,396
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.