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 $2,344.23 Median $5,495.41 Typical High $9,549.93 | Facility | None | $2,344.23 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,659.59 | $1,905.46 | $2,344.23 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $1,412.54 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,412.54 | $2,089.30 | $3,019.95 |
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 $1,548.82 Median $1,819.70 Typical High $10,715.19 | Professional | None | $1,548.82 | $1,819.70 | $10,715.19 |
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 $1,513.56 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,778.28 | $2,691.53 |
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 $831.76 Median $954.99 Typical High $1,174.90 | Professional | 52 · Reduced service | $831.76 | $954.99 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $380.19 Typical High $467.74 | Professional | 53 · Discontinued | $331.13 | $380.19 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,445.44 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,258.93 | $1,445.44 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $288.40 Typical High $354.81 | Professional | 55 · Aftercare only | $251.19 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $190.55 Typical High $234.42 | Professional | 56 · Pre-op care only | $165.96 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,348.96 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,348.96 | $1,659.59 |
Where Kansas sits
The same service costs 5.9 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· 28th of 51
$1,905
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.