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 $1,348.96 Median $3,162.28 Typical High $7,943.28 | Facility | None | $1,348.96 | $3,162.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $512.86 | Professional | None | $346.74 | $407.38 | $512.86 |
BCBS Kansas Setting Facility Modifier None Typical Low $1,905.46 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,905.46 | $1,995.26 | $1,995.26 |
BCBS Kansas Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $2,089.30 Typical High $2,344.23 | Facility | None | $380.19 | $2,089.30 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $691.83 | Professional | None | $323.59 | $457.09 | $691.83 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $1,698.24 Typical High $12,022.64 | Facility | None | $537.03 | $1,698.24 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $2,691.53 | Professional | None | $323.59 | $371.54 | $2,691.53 |
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 $316.23 Median $371.54 Typical High $676.08 | Professional | None | $316.23 | $371.54 | $676.08 |
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 $173.78 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $173.78 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $81.28 Typical High $102.33 | Professional | 53 · Discontinued | $69.18 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $309.03 Typical High $380.19 | Professional | 54 · Surgery only | $263.03 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $52.48 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $40.74 Typical High $51.29 | Professional | 56 · Pre-op care only | $34.67 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $288.40 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $245.47 | $288.40 | $354.81 |
Where Kansas sits
The same service costs 8.5 times more in Oklahoma 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· 4th of 51
$1,288
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.