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 $3,801.89 Median $4,265.80 Typical High $5,754.40 | Professional | None | $3,801.89 | $4,265.80 | $5,754.40 |
BCBS Kansas Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $5,888.44 | Facility | None | $54.95 | $1,000.00 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $3,715.35 Median $7,244.36 Typical High $25,703.96 | Professional | None | $3,715.35 | $7,244.36 | $25,703.96 |
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 $3,467.37 Median $4,365.16 Typical High $6,025.60 | Professional | None | $3,467.37 | $4,365.16 | $6,025.60 |
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 $1,905.46 Median $2,137.96 Typical High $2,884.03 | Professional | 52 · Reduced service | $1,905.46 | $2,137.96 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $851.14 Typical High $1,174.90 | Professional | 53 · Discontinued | $758.58 | $851.14 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $3,162.28 Typical High $4,365.16 | Professional | 54 · Surgery only | $2,818.38 | $3,162.28 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $630.96 Typical High $870.96 | Professional | 55 · Aftercare only | $562.34 | $630.96 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $426.58 Typical High $575.44 | Professional | 56 · Pre-op care only | $380.19 | $426.58 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,951.21 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,951.21 | $4,073.80 |
Where Kansas sits
The same service costs 27.5 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· 27th of 51
$4,365
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.