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 $2,511.89 Median $5,495.41 Typical High $9,549.93 | Facility | None | $2,511.89 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,905.46 | $2,511.89 | $2,511.89 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $1,621.81 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,621.81 | $2,290.87 | $3,235.94 |
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 $1,621.81 Median $2,398.83 Typical High $18,620.87 | Professional | None | $1,621.81 | $2,398.83 | $18,620.87 |
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 $1,584.89 Median $2,398.83 Typical High $3,311.31 | Professional | None | $1,584.89 | $2,398.83 | $3,311.31 |
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 $954.99 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $954.99 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $501.19 Typical High $512.86 | Professional | 53 · Discontinued | $380.19 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,445.44 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $288.40 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $190.55 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,778.28 | $1,778.28 |
Where Kansas sits
The same service costs 5.6 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
$2,399
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.