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 $165.96 Median $234.42 Typical High $354.81 | Professional | None | $165.96 | $234.42 | $354.81 |
BCBS Kansas Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
BCBS Kansas Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $269.15 | Professional | None | $194.98 | $194.98 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $912.01 Typical High $933.25 | Facility | None | $380.19 | $912.01 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $338.84 | Professional | None | $158.49 | $229.09 | $338.84 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $912.01 Typical High $12,022.64 | Facility | None | $263.03 | $912.01 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $1,174.90 Typical High $1,621.81 | Professional | None | $229.09 | $1,174.90 | $1,621.81 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,047.13 Typical High $3,311.31 | Facility | None | $501.19 | $1,047.13 | $3,311.31 |
United Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $316.23 | Professional | None | $165.96 | $213.80 | $316.23 |
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 $81.28 Median $114.82 Typical High $177.83 | Professional | 52 · Reduced service | $81.28 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $45.71 Typical High $70.79 | Professional | 53 · Discontinued | $33.11 | $45.71 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $169.82 Typical High $263.03 | Professional | 54 · Surgery only | $123.03 | $169.82 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $33.88 Typical High $52.48 | Professional | 55 · Aftercare only | $24.55 | $33.88 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $22.91 Typical High $35.48 | Professional | 56 · Pre-op care only | $16.60 | $22.91 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $158.49 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $114.82 | $158.49 | $245.47 |
Where Kansas sits
The same service costs 4.2 times more in Alaska than in New Jersey. 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· 17th of 51
$263
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.