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 $1,148.15 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,548.82 | $1,548.82 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $2,238.72 | Facility | None | $676.08 | $2,137.96 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $1,737.80 | Professional | None | $977.24 | $1,445.44 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,819.70 Typical High $6,309.57 | Facility | None | $54.95 | $1,819.70 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $6,606.93 | Professional | None | $1,071.52 | $1,479.11 | $6,606.93 |
United Setting Facility Modifier None Typical Low $691.83 Median $2,187.76 Typical High $6,760.83 | Facility | None | $691.83 | $2,187.76 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,479.11 | $2,041.74 |
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 $575.44 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $575.44 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $234.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $870.96 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $173.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $114.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $812.83 | $1,096.48 | $1,096.48 |
Where Kansas sits
The same service costs 4.7 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· 25th of 51
$1,549
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.