How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,318 to $9,550Professionalmedian $813 · 10th to 90th $550 to $5,248
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 $549.54 Median $691.83 Typical High $851.14 | Professional | None | $549.54 | $691.83 | $851.14 |
BCBS Kansas Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $3,090.30 | Facility | None | $2,818.38 | $3,019.95 | $3,090.30 |
BCBS Kansas Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,897.79 Typical High $5,011.87 | Facility | None | $676.08 | $4,897.79 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $870.96 | Professional | None | $575.44 | $831.76 | $870.96 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $3,715.35 Typical High $26,302.68 | Facility | None | $831.76 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $5,248.07 | Professional | None | $588.84 | $741.31 | $5,248.07 |
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 $549.54 Median $630.96 Typical High $891.25 | Professional | None | $549.54 | $630.96 | $891.25 |
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 $275.42 Median $346.74 Typical High $426.58 | Professional | 52 · Reduced service | $275.42 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $138.04 Typical High $169.82 | Professional | 53 · Discontinued | $109.65 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $512.86 Typical High $645.65 | Professional | 54 · Surgery only | $416.87 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $102.33 Typical High $128.82 | Professional | 55 · Aftercare only | $83.18 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $69.18 Typical High $85.11 | Professional | 56 · Pre-op care only | $54.95 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $478.63 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $389.05 | $478.63 | $602.56 |
Where Kansas sits
The same service costs 7.9 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 $13,941MT $1,762
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.