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 $1,949.84 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,949.84 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,412.54 | $1,905.46 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $1,258.93 Median $1,659.59 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,659.59 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $4,466.84 | Facility | None | $54.95 | $1,000.00 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $2,454.71 Typical High $8,511.38 | Professional | None | $1,230.27 | $2,454.71 | $8,511.38 |
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 $1,148.15 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,148.15 | $1,445.44 | $1,995.26 |
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 $616.60 Median $707.95 Typical High $954.99 | Professional | 52 · Reduced service | $616.60 | $707.95 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $281.84 Typical High $389.05 | Professional | 53 · Discontinued | $251.19 | $281.84 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,047.13 Typical High $1,445.44 | Professional | 54 · Surgery only | $933.25 | $1,047.13 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $288.40 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $141.25 Typical High $190.55 | Professional | 56 · Pre-op care only | $125.89 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $977.24 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $870.96 | $977.24 | $1,348.96 |
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· 24th of 51
$1,549
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.