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 $5,888.44 Typical High $9,549.93 | Facility | None | $3,162.28 | $5,888.44 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $3,630.78 Typical High $3,630.78 | Professional | None | $2,691.53 | $3,630.78 | $3,630.78 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
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 $2,089.30 Median $3,019.95 Typical High $3,890.45 | Professional | None | $2,089.30 | $3,019.95 | $3,890.45 |
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 $1,659.59 Median $3,388.44 Typical High $15,488.17 | Professional | None | $1,659.59 | $3,388.44 | $15,488.17 |
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 $1,659.59 Median $3,235.94 Typical High $4,677.35 | Professional | None | $1,659.59 | $3,235.94 | $4,677.35 |
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 $1,348.96 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,348.96 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $549.54 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,041.74 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $407.38 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $269.15 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,511.89 | $2,511.89 |
Where Kansas sits
The same service costs 5.8 times more in Alaska than in Delaware. 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· 19th of 51
$2,884
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.