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 $2,884.03 Median $6,309.57 Typical High $13,182.57 | Facility | None | $2,884.03 | $6,309.57 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,884.03 | Professional | None | $1,905.46 | $2,238.72 | $2,884.03 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $707.95 Typical High $4,168.69 | Facility | None | $478.63 | $707.95 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $2,884.03 | Professional | None | $1,949.84 | $2,630.27 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $2,238.72 Typical High $5,011.87 | Facility | None | $446.68 | $2,238.72 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $13,182.57 | Professional | None | $1,949.84 | $2,344.23 | $13,182.57 |
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 $1,862.09 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,862.09 | $2,238.72 | $3,019.95 |
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 $933.25 Median $1,122.02 Typical High $1,445.44 | Professional | 52 · Reduced service | $933.25 | $1,122.02 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $457.09 Typical High $588.84 | Professional | 53 · Discontinued | $380.19 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,698.24 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,412.54 | $1,698.24 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $338.84 Typical High $436.52 | Professional | 55 · Aftercare only | $281.84 | $338.84 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $223.87 Typical High $288.40 | Professional | 56 · Pre-op care only | $190.55 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,584.89 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,584.89 | $2,041.74 |
Where Kansas sits
The same service costs 5.9 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· 21st of 51
$2,512
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.