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 $123.03 Median $208.93 Typical High $371.54 | Professional | None | $123.03 | $208.93 | $371.54 |
BCBS Kansas Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
BCBS Kansas Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $302.00 | Professional | None | $165.96 | $165.96 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $436.52 Typical High $436.52 | Facility | None | $154.88 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $331.13 | Professional | None | $125.89 | $229.09 | $331.13 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $380.19 Typical High $12,022.64 | Facility | None | $147.91 | $380.19 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $870.96 Typical High $1,698.24 | Professional | None | $239.88 | $870.96 | $1,698.24 |
United Setting Facility Modifier None Typical Low $125.89 Median $398.11 Typical High $1,778.28 | Facility | None | $125.89 | $398.11 | $1,778.28 |
United Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $281.84 | Professional | None | $128.82 | $213.80 | $281.84 |
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 $61.66 Median $100.00 Typical High $186.21 | Professional | 52 · Reduced service | $61.66 | $100.00 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $39.81 Typical High $74.13 | Professional | 53 · Discontinued | $24.55 | $39.81 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $151.36 Typical High $281.84 | Professional | 54 · Surgery only | $93.33 | $151.36 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $30.20 Typical High $56.23 | Professional | 55 · Aftercare only | $18.62 | $30.20 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $19.95 Typical High $37.15 | Professional | 56 · Pre-op care only | $12.30 | $19.95 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $141.25 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $87.10 | $141.25 | $263.03 |
Where Kansas sits
The same service costs 3.5 times more in Alaska 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· 13th of 51
$257
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.