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 $954.99 Median $3,162.28 Typical High $7,943.28 | Facility | None | $954.99 | $3,162.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $416.87 | Professional | None | $169.82 | $269.15 | $416.87 |
BCBS Kansas Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
BCBS Kansas Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $354.81 | Professional | None | $229.09 | $229.09 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $707.95 Typical High $1,258.93 | Facility | None | $245.47 | $707.95 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $446.68 | Professional | None | $173.78 | $275.42 | $446.68 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $575.44 Typical High $2,691.53 | Facility | None | $54.95 | $575.44 | $2,691.53 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $549.54 Typical High $1,905.46 | Professional | None | $257.04 | $549.54 | $1,905.46 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,047.13 Typical High $3,388.44 | Facility | None | $501.19 | $1,047.13 | $3,388.44 |
United Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $389.05 | Professional | None | $173.78 | $257.04 | $389.05 |
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 $85.11 Median $134.90 Typical High $208.93 | Professional | 52 · Reduced service | $85.11 | $134.90 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $54.95 Typical High $83.18 | Professional | 53 · Discontinued | $33.88 | $54.95 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $204.17 Typical High $309.03 | Professional | 54 · Surgery only | $128.82 | $204.17 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $40.74 Typical High $61.66 | Professional | 55 · Aftercare only | $25.70 | $40.74 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $26.92 Typical High $41.69 | Professional | 56 · Pre-op care only | $16.98 | $26.92 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $190.55 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $120.23 | $190.55 | $288.40 |
Where Kansas sits
The same service costs 4.3 times more in Wisconsin 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· 21st of 51
$309
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.