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 $1,023.29 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,174.90 | $1,445.44 |
BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $2,041.74 | Facility | None | $446.68 | $645.65 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,819.70 | Professional | None | $851.14 | $1,258.93 | $1,819.70 |
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 $933.25 Median $1,096.48 Typical High $6,606.93 | Professional | None | $933.25 | $1,096.48 | $6,606.93 |
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 $933.25 Median $1,096.48 Typical High $1,659.59 | Professional | None | $933.25 | $1,096.48 | $1,659.59 |
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 $512.86 Median $588.84 Typical High $724.44 | Professional | 52 · Reduced service | $512.86 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $234.42 Typical High $288.40 | Professional | 53 · Discontinued | $204.17 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $870.96 Typical High $1,071.52 | Professional | 54 · Surgery only | $758.58 | $870.96 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $173.78 Typical High $218.78 | Professional | 55 · Aftercare only | $151.36 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $117.49 Typical High $144.54 | Professional | 56 · Pre-op care only | $102.33 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $812.83 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $707.95 | $812.83 | $1,000.00 |
Where Kansas sits
The same service costs 5.6 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
$1,175
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.