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 $2,691.53 Median $6,309.57 Typical High $13,182.57 | Facility | None | $2,691.53 | $6,309.57 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $2,691.53 | Professional | None | $1,737.80 | $2,089.30 | $2,691.53 |
BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,174.90 Typical High $4,168.69 | Facility | None | $478.63 | $1,174.90 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,398.83 Typical High $2,570.40 | Professional | None | $1,659.59 | $2,398.83 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $2,089.30 Typical High $5,011.87 | Facility | None | $446.68 | $2,089.30 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $2,187.76 Typical High $12,302.69 | Professional | None | $1,698.24 | $2,187.76 | $12,302.69 |
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 $1,659.59 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,659.59 | $2,041.74 | $2,754.23 |
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 $870.96 Median $1,047.13 Typical High $1,348.96 | Professional | 52 · Reduced service | $870.96 | $1,047.13 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $416.87 Typical High $537.03 | Professional | 53 · Discontinued | $346.74 | $416.87 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,548.82 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,288.25 | $1,548.82 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $309.03 Typical High $398.11 | Professional | 55 · Aftercare only | $257.04 | $309.03 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $208.93 Typical High $269.15 | Professional | 56 · Pre-op care only | $173.78 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,445.44 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,445.44 | $1,862.09 |
Where Kansas sits
The same service costs 6.0 times more in Alaska than in Texas. 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· 22nd of 51
$2,239
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.