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 $954.99 Median $3,162.28 Typical High $7,943.28 | Facility | None | $954.99 | $3,162.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $295.12 | Professional | None | $112.20 | $181.97 | $295.12 |
BCBS Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
BCBS Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $213.80 | Professional | None | $141.25 | $141.25 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $154.88 Typical High $177.83 | Facility | None | $123.03 | $154.88 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $309.03 | Professional | None | $107.15 | $181.97 | $309.03 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $288.40 Typical High $1,380.38 | Facility | None | $54.95 | $288.40 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $380.19 Typical High $1,380.38 | Professional | None | $181.97 | $380.19 | $1,380.38 |
United Setting Facility Modifier None Typical Low $125.89 Median $398.11 Typical High $1,778.28 | Facility | None | $125.89 | $398.11 | $1,778.28 |
United Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $269.15 | Professional | None | $112.20 | $181.97 | $269.15 |
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 $56.23 Median $91.20 Typical High $147.91 | Professional | 52 · Reduced service | $56.23 | $91.20 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $36.31 Typical High $58.88 | Professional | 53 · Discontinued | $22.39 | $36.31 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $134.90 Typical High $223.87 | Professional | 54 · Surgery only | $83.18 | $134.90 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $26.92 Typical High $44.67 | Professional | 55 · Aftercare only | $16.60 | $26.92 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $18.20 Typical High $29.51 | Professional | 56 · Pre-op care only | $11.22 | $18.20 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $125.89 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $77.62 | $125.89 | $208.93 |
Where Kansas sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 16th of 51
$214
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.