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 $2,630.27 Median $4,677.35 Typical High $9,549.93 | Facility | None | $2,630.27 | $4,677.35 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,949.84 | $2,630.27 | $2,630.27 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
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 $1,698.24 Median $2,398.83 Typical High $3,388.44 | Professional | None | $1,698.24 | $2,398.83 | $3,388.44 |
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 $1,737.80 Median $2,454.71 Typical High $21,877.62 | Professional | None | $1,737.80 | $2,454.71 | $21,877.62 |
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 $1,659.59 Median $2,454.71 Typical High $3,388.44 | Professional | None | $1,659.59 | $2,454.71 | $3,388.44 |
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 $977.24 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $977.24 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $398.11 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,479.11 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $389.05 Typical High $398.11 | Professional | 55 · Aftercare only | $295.12 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $194.98 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,819.70 | $1,819.70 |
Where Kansas sits
The same service costs 5.5 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
$2,455
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.