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 $3,162.28 Median $7,762.47 Typical High $15,135.61 | Facility | None | $3,162.28 | $7,762.47 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,951.21 | Professional | None | $1,905.46 | $2,137.96 | $2,951.21 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $2,041.74 | Facility | None | $446.68 | $676.08 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,511.89 Typical High $3,388.44 | Professional | None | $1,905.46 | $2,511.89 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $4,570.88 | Facility | None | $54.95 | $1,000.00 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $1,862.09 Median $3,715.35 Typical High $13,182.57 | Professional | None | $1,862.09 | $3,715.35 | $13,182.57 |
United Setting Facility Modifier None Typical Low $407.38 Median $1,000.00 Typical High $5,248.07 | Facility | None | $407.38 | $1,000.00 | $5,248.07 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,778.28 | $2,187.76 | $3,090.30 |
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 $954.99 Median $1,071.52 Typical High $1,479.11 | Professional | 52 · Reduced service | $954.99 | $1,071.52 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $426.58 Typical High $588.84 | Professional | 53 · Discontinued | $380.19 | $426.58 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,621.81 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,445.44 | $1,621.81 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $323.59 Typical High $436.52 | Professional | 55 · Aftercare only | $288.40 | $323.59 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $213.80 Typical High $295.12 | Professional | 56 · Pre-op care only | $190.55 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,513.56 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,513.56 | $2,041.74 |
Where Kansas sits
The same service costs 5.4 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· 23rd of 51
$2,344
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.