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 $6,309.57 Typical High $9,549.93 | Facility | None | $3,162.28 | $6,309.57 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $4,466.84 | Professional | None | $3,388.44 | $4,466.84 | $4,466.84 |
BCBS Kansas Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $2,951.21 Median $4,168.69 Typical High $5,011.87 | Professional | None | $2,951.21 | $4,168.69 | $5,011.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $5,011.87 | Facility | None | $54.95 | $1,000.00 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $2,691.53 Median $4,265.80 Typical High $25,703.96 | Professional | None | $2,691.53 | $4,265.80 | $25,703.96 |
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 $2,630.27 Median $4,265.80 Typical High $5,888.44 | Professional | None | $2,630.27 | $4,265.80 | $5,888.44 |
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 $1,659.59 Median $2,238.72 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,659.59 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $891.25 Typical High $891.25 | Professional | 53 · Discontinued | $676.08 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $3,311.31 Typical High $3,388.44 | Professional | 54 · Surgery only | $2,511.89 | $3,311.31 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $660.69 Typical High $676.08 | Professional | 55 · Aftercare only | $501.19 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $446.68 Typical High $446.68 | Professional | 56 · Pre-op care only | $338.84 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $3,090.30 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $2,344.23 | $3,090.30 | $3,162.28 |
Where Kansas sits
The same service costs 6.9 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· 26th of 51
$3,631
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.