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 $1,174.90 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,584.89 | $1,584.89 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $1,047.13 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,479.11 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,862.09 Typical High $6,309.57 | Facility | None | $54.95 | $1,862.09 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $7,413.10 | Professional | None | $1,122.02 | $1,513.56 | $7,413.10 |
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 $1,096.48 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,513.56 | $2,089.30 |
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 $588.84 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $588.84 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $234.42 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $891.25 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $177.83 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $117.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $831.76 | $1,122.02 | $1,122.02 |
Where Kansas sits
The same service costs 4.6 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· 27th 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.