How much rates vary
Facilitymedian $1,072 · 10th to 90th $123 to $6,607Professionalmedian $6,457 · 10th to 90th $4,169 to $154,882
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 $3,162.28 Median $6,309.57 Typical High $10,232.93 | Facility | None | $3,162.28 | $6,309.57 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $4,897.79 Median $6,165.95 Typical High $7,585.78 | Professional | None | $4,897.79 | $6,165.95 | $7,585.78 |
BCBS Kansas Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $6,025.60 | Facility | None | $54.95 | $1,000.00 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $3,981.07 Median $6,456.54 Typical High $154,881.66 | Professional | None | $3,981.07 | $6,456.54 | $154,881.66 |
United Setting Facility Modifier None Typical Low $407.38 Median $1,000.00 Typical High $5,248.07 | Facility | None | $407.38 | $1,000.00 | $5,248.07 |
United Setting Professional Modifier None Typical Low $3,890.45 Median $6,309.57 Typical High $9,120.11 | Professional | None | $3,890.45 | $6,309.57 | $9,120.11 |
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 $2,398.83 Median $3,090.30 Typical High $3,801.89 | Professional | 52 · Reduced service | $2,398.83 | $3,090.30 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $1,230.27 Typical High $1,513.56 | Professional | 53 · Discontinued | $977.24 | $1,230.27 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $4,570.88 Typical High $5,623.41 | Professional | 54 · Surgery only | $3,630.78 | $4,570.88 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $912.01 Typical High $1,148.15 | Professional | 55 · Aftercare only | $724.44 | $912.01 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $616.60 Typical High $758.58 | Professional | 56 · Pre-op care only | $489.78 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $4,265.80 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $3,388.44 | $4,265.80 | $5,248.07 |
Where Kansas sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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
WI $28,671TX $3,407
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.