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 $6,309.57 Typical High $9,549.93 | Facility | None | $3,162.28 | $6,309.57 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $4,466.84 Median $5,011.87 Typical High $6,918.31 | Professional | None | $4,466.84 | $5,011.87 | $6,918.31 |
BCBS Kansas Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
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 $4,265.80 Median $5,754.40 Typical High $7,585.78 | Professional | None | $4,265.80 | $5,754.40 | $7,585.78 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $6,760.83 | Facility | None | $54.95 | $1,000.00 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $4,168.69 Median $8,709.64 Typical High $31,622.78 | Professional | None | $4,168.69 | $8,709.64 | $31,622.78 |
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 $3,890.45 Median $5,128.61 Typical High $7,079.46 | Professional | None | $3,890.45 | $5,128.61 | $7,079.46 |
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 $2,238.72 Median $2,511.89 Typical High $3,388.44 | Professional | 52 · Reduced service | $2,238.72 | $2,511.89 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $1,000.00 Typical High $1,380.38 | Professional | 53 · Discontinued | $891.25 | $1,000.00 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,715.35 Typical High $5,128.61 | Professional | 54 · Surgery only | $3,311.31 | $3,715.35 | $5,128.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $741.31 Typical High $1,023.29 | Professional | 55 · Aftercare only | $660.69 | $741.31 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $501.19 Typical High $691.83 | Professional | 56 · Pre-op care only | $446.68 | $501.19 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,467.37 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,467.37 | $4,786.30 |
Where Kansas sits
The same service costs 21.9 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· 22nd of 51
$5,248
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.