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 $2,290.87 Median $5,495.41 Typical High $9,549.93 | Facility | None | $2,290.87 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,698.24 | $2,290.87 | $2,290.87 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $2,041.74 | Facility | None | $446.68 | $676.08 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,513.56 | $2,089.30 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $4,466.84 | Facility | None | $54.95 | $1,000.00 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $12,589.25 | Professional | None | $1,479.11 | $2,137.96 | $12,589.25 |
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 $1,412.54 Median $2,137.96 Typical High $2,951.21 | Professional | None | $1,412.54 | $2,137.96 | $2,951.21 |
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 $851.14 Median $1,122.02 Typical High $1,148.15 | Professional | 52 · Reduced service | $851.14 | $1,122.02 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $338.84 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,288.25 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $257.04 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $169.82 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,584.89 | $1,584.89 |
Where Kansas sits
The same service costs 5.4 times more in Alaska 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.
Kansas· 16th of 51
$2,089
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.