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 $3,162.28 Median $5,495.41 Typical High $9,549.93 | Facility | None | $3,162.28 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,511.89 | $3,388.44 | $3,388.44 |
BCBS Kansas Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
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 $2,238.72 Median $3,162.28 Typical High $3,801.89 | Professional | None | $2,238.72 | $3,162.28 | $3,801.89 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $4,570.88 | Facility | None | $54.95 | $1,000.00 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $2,041.74 Median $3,235.94 Typical High $20,417.38 | Professional | None | $2,041.74 | $3,235.94 | $20,417.38 |
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 $1,995.26 Median $3,235.94 Typical High $4,466.84 | Professional | None | $1,995.26 | $3,235.94 | $4,466.84 |
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 $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,258.93 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $512.86 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,511.89 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,905.46 | $2,511.89 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $380.19 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $251.19 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,344.23 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,344.23 | $2,398.83 |
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· 15th of 51
$3,090
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.