How much rates vary
Facilitymedian $1,380 · 10th to 90th $891 to $5,370Professionalmedian $257 · 10th to 90th $182 to $1,820
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 $1,000.00 Median $3,630.78 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $275.42 | Professional | None | $173.78 | $208.93 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
BCBS Kansas Setting Facility Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,288.25 | $1,380.38 | $1,380.38 |
BCBS Kansas Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,089.30 Typical High $2,344.23 | Facility | None | $524.81 | $2,089.30 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $380.19 | Professional | None | $173.78 | $257.04 | $380.19 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $1,698.24 Typical High $16,218.10 | Facility | None | $316.23 | $1,698.24 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $1,862.09 | Professional | None | $194.98 | $223.87 | $1,862.09 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,737.80 Typical High $4,677.35 | Facility | None | $831.76 | $1,737.80 | $4,677.35 |
United Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $338.84 | Professional | None | $186.21 | $204.17 | $338.84 |
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 $89.13 Median $104.71 Typical High $131.83 | Professional | 52 · Reduced service | $89.13 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $41.69 Typical High $52.48 | Professional | 53 · Discontinued | $35.48 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $158.49 Typical High $194.98 | Professional | 54 · Surgery only | $134.90 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $31.62 Typical High $39.81 | Professional | 55 · Aftercare only | $26.92 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.89 Typical High $26.30 | Professional | 56 · Pre-op care only | $17.78 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $147.91 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $125.89 | $147.91 | $181.97 |
Where Kansas sits
The same service costs 8.1 times more in Colorado than in Montana. 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
CO $4,634MT $570
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.