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 $2,290.87 Median $5,495.41 Typical High $9,549.93 | Facility | None | $2,290.87 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $2,344.23 | Professional | None | $1,737.80 | $2,290.87 | $2,344.23 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
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 $1,513.56 Median $2,137.96 Typical High $2,818.38 | Professional | None | $1,513.56 | $2,137.96 | $2,818.38 |
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 $1,513.56 Median $2,187.76 Typical High $19,498.45 | Professional | None | $1,513.56 | $2,187.76 | $19,498.45 |
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 $1,445.44 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,445.44 | $2,187.76 | $3,019.95 |
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 $870.96 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $870.96 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $457.09 Typical High $467.74 | Professional | 53 · Discontinued | $346.74 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,318.26 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $263.03 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $229.09 Typical High $234.42 | Professional | 56 · Pre-op care only | $173.78 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,621.81 | $1,621.81 |
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· 17th of 51
$2,188
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.