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 $933.25 Median $1,230.27 Typical High $1,230.27 | Professional | None | $933.25 | $1,230.27 | $1,230.27 |
BCBS Kansas Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
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 $724.44 Median $870.96 Typical High $1,202.26 | Professional | None | $724.44 | $870.96 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,445.44 Typical High $6,606.93 | Facility | None | $54.95 | $1,445.44 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,122.02 Typical High $5,248.07 | Professional | None | $562.34 | $1,122.02 | $5,248.07 |
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 $588.84 Median $1,071.52 Typical High $1,513.56 | Professional | None | $588.84 | $1,071.52 | $1,513.56 |
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 $467.74 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $467.74 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $186.21 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $912.01 Typical High $933.25 | Professional | 54 · Surgery only | $691.83 | $912.01 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $181.97 Typical High $186.21 | Professional | 55 · Aftercare only | $138.04 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $93.33 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $851.14 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $645.65 | $851.14 | $870.96 |
Where Kansas sits
The same service costs 6.8 times more in Oklahoma than in Kentucky. 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· 24th of 51
$1,148
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.