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 $5,128.61 Typical High $9,549.93 | Facility | None | $1,949.84 | $5,128.61 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $467.74 | Professional | None | $346.74 | $398.11 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $630.96 | Professional | None | $398.11 | $416.87 | $630.96 |
BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $1,995.26 | Facility | None | $1,445.44 | $1,548.82 | $1,995.26 |
BCBS Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $676.08 | Professional | None | $588.84 | $588.84 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,398.83 | Facility | None | $912.01 | $2,089.30 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $831.76 | Professional | None | $371.54 | $489.78 | $831.76 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $1,412.54 Typical High $26,302.68 | Facility | None | $501.19 | $1,412.54 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $851.14 Typical High $3,090.30 | Professional | None | $389.05 | $851.14 | $3,090.30 |
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 $354.81 Median $407.38 Typical High $707.95 | Professional | None | $354.81 | $407.38 | $707.95 |
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 $173.78 Median $199.53 Typical High $234.42 | Professional | 52 · Reduced service | $173.78 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $79.43 Typical High $93.33 | Professional | 53 · Discontinued | $69.18 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $346.74 | Professional | 54 · Surgery only | $257.04 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $60.26 Typical High $70.79 | Professional | 55 · Aftercare only | $51.29 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $39.81 Typical High $46.77 | Professional | 56 · Pre-op care only | $34.67 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $281.84 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $239.88 | $281.84 | $323.59 |
Where Kansas sits
The same service costs 3.8 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· 11th of 51
$676
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.