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 $467.74 Median $4,677.35 Typical High $10,715.19 | Facility | None | $467.74 | $4,677.35 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $354.81 | Professional | None | $223.87 | $263.03 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $181.97 | Professional | None | $95.50 | $95.50 | $181.97 |
BCBS Kansas Setting Facility Modifier None Typical Low $1,737.80 Median $3,890.45 Typical High $4,073.80 | Facility | None | $1,737.80 | $3,890.45 | $4,073.80 |
BCBS Kansas Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,137.96 Typical High $2,454.71 | Facility | None | $741.31 | $2,137.96 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $389.05 | Professional | None | $213.80 | $346.74 | $389.05 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $1,737.80 Typical High $26,302.68 | Facility | None | $354.81 | $1,737.80 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $426.58 Typical High $1,584.89 | Professional | None | $223.87 | $426.58 | $1,584.89 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,737.80 Typical High $4,786.30 | Facility | None | $831.76 | $1,737.80 | $4,786.30 |
United Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $354.81 | Professional | None | $208.93 | $245.47 | $354.81 |
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 $112.20 Median $131.83 Typical High $177.83 | Professional | 52 · Reduced service | $112.20 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $52.48 Typical High $72.44 | Professional | 53 · Discontinued | $44.67 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $194.98 Typical High $269.15 | Professional | 54 · Surgery only | $169.82 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.90 Typical High $53.70 | Professional | 55 · Aftercare only | $33.88 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.30 Typical High $35.48 | Professional | 56 · Pre-op care only | $22.39 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $181.97 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $158.49 | $181.97 | $251.19 |
Where Kansas sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 16th of 51
$324
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.