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 $295.12 Median $4,677.35 Typical High $9,549.93 | Facility | None | $295.12 | $4,677.35 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $269.15 | Professional | None | $141.25 | $208.93 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $223.87 | Professional | None | $141.25 | $141.25 | $223.87 |
BCBS Kansas Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $177.83 | Professional | None | $141.25 | $141.25 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $57.54 | Facility | None | $52.48 | $52.48 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $251.19 | Professional | None | $123.03 | $165.96 | $251.19 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $251.19 Typical High $1,288.25 | Facility | None | $54.95 | $251.19 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $295.12 Typical High $1,096.48 | Professional | None | $138.04 | $295.12 | $1,096.48 |
United Setting Facility Modifier None Typical Low $125.89 Median $398.11 Typical High $1,778.28 | Facility | None | $125.89 | $398.11 | $1,778.28 |
United Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $239.88 | Professional | None | $112.20 | $141.25 | $239.88 |
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 $70.79 Median $104.71 Typical High $134.90 | Professional | 52 · Reduced service | $70.79 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $41.69 Typical High $53.70 | Professional | 53 · Discontinued | $28.18 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $158.49 Typical High $199.53 | Professional | 54 · Surgery only | $107.15 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $31.62 Typical High $40.74 | Professional | 55 · Aftercare only | $21.38 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.89 Typical High $26.92 | Professional | 56 · Pre-op care only | $14.13 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $147.91 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $100.00 | $147.91 | $186.21 |
Where Kansas sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 21st of 51
$178
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.