How much rates vary
Facilitymedian $1,072 · 10th to 90th $123 to $5,754Professionalmedian $1,585 · 10th to 90th $1,202 to $8,913
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 $1,412.54 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,584.89 | $1,949.84 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $1,148.15 Median $1,479.11 Typical High $8,912.51 | Professional | None | $1,148.15 | $1,479.11 | $8,912.51 |
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 $1,096.48 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,380.38 | $2,290.87 |
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 $707.95 Median $794.33 Typical High $977.24 | Professional | 52 · Reduced service | $707.95 | $794.33 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $389.05 | Professional | 53 · Discontinued | $281.84 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $234.42 Typical High $295.12 | Professional | 55 · Aftercare only | $208.93 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $158.49 Typical High $194.98 | Professional | 56 · Pre-op care only | $141.25 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,096.48 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $977.24 | $1,096.48 | $1,348.96 |
Where Kansas sits
The same service costs 6.7 times more in Alabama than in Delaware. 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.
Physician feeFacility fee
AL $11,549DE $1,727
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.