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 $1,949.84 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,949.84 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,621.81 | $1,621.81 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,168.69 Typical High $4,365.16 | Facility | None | $676.08 | $4,168.69 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,513.56 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,691.53 Typical High $11,748.98 | Facility | None | $54.95 | $2,691.53 | $11,748.98 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $6,918.31 | Professional | None | $1,122.02 | $1,584.89 | $6,918.31 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,302.69 | Facility | None | $933.25 | $3,548.13 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,584.89 | $2,137.96 |
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 $602.56 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $602.56 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $245.47 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $912.01 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $181.97 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $123.03 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $851.14 | $1,148.15 | $1,148.15 |
Where Kansas sits
The same service costs 5.0 times more in Wisconsin 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· 28th of 51
$1,622
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.