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 $1,698.24 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,698.24 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $467.74 | Professional | None | $389.05 | $457.09 | $467.74 |
BCBS Kansas Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
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 $380.19 Median $602.56 Typical High $891.25 | Professional | None | $380.19 | $602.56 | $891.25 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $602.56 Typical High $4,466.84 | Facility | None | $54.95 | $602.56 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $3,090.30 | Professional | None | $407.38 | $501.19 | $3,090.30 |
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 $407.38 Median $457.09 Typical High $724.44 | Professional | None | $407.38 | $457.09 | $724.44 |
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 $194.98 Median $229.09 Typical High $234.42 | Professional | 52 · Reduced service | $194.98 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $91.20 Typical High $93.33 | Professional | 53 · Discontinued | $77.62 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $338.84 Typical High $346.74 | Professional | 54 · Surgery only | $295.12 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $67.61 Typical High $70.79 | Professional | 55 · Aftercare only | $58.88 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $45.71 Typical High $46.77 | Professional | 56 · Pre-op care only | $38.90 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $316.23 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $275.42 | $316.23 | $323.59 |
Where Kansas sits
The same service costs 5.0 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· 23rd of 51
$603
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.