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 $2,630.27 Median $5,495.41 Typical High $9,549.93 | Facility | None | $2,630.27 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,137.96 | $2,630.27 |
BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $1,584.89 Median $2,344.23 Typical High $3,388.44 | Professional | None | $1,584.89 | $2,344.23 | $3,388.44 |
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 $1,737.80 Median $1,995.26 Typical High $15,488.17 | Professional | None | $1,737.80 | $1,995.26 | $15,488.17 |
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 $1,698.24 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,698.24 | $1,995.26 | $3,019.95 |
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 $933.25 Median $1,071.52 Typical High $1,318.26 | Professional | 52 · Reduced service | $933.25 | $1,071.52 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $426.58 Typical High $537.03 | Professional | 53 · Discontinued | $371.54 | $426.58 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,621.81 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,412.54 | $1,621.81 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $323.59 Typical High $398.11 | Professional | 55 · Aftercare only | $281.84 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $213.80 Typical High $263.03 | Professional | 56 · Pre-op care only | $186.21 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,513.56 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,513.56 | $1,862.09 |
Where Kansas sits
The same service costs 6.8 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· 30th of 51
$2,042
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.