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 $2,398.83 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,398.83 | $3,235.94 | $3,235.94 |
BCBS Kansas Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
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 $2,137.96 Median $3,019.95 Typical High $4,073.80 | Professional | None | $2,137.96 | $3,019.95 | $4,073.80 |
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 $2,137.96 Median $3,090.30 Typical High $22,387.21 | Professional | None | $2,137.96 | $3,090.30 | $22,387.21 |
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 $2,041.74 Median $3,090.30 Typical High $4,265.80 | Professional | None | $2,041.74 | $3,090.30 | $4,265.80 |
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 $1,202.26 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,202.26 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $478.63 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,819.70 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $478.63 Typical High $489.78 | Professional | 55 · Aftercare only | $363.08 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $239.88 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,238.72 | $2,238.72 |
Where Kansas sits
The same service costs 5.8 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· 17th of 51
$3,020
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.