How much rates vary
Facilitymedian $2,344 · 10th to 90th $891 to $4,571Professionalmedian $490 · 10th to 90th $245 to $1,660
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 $323.59 Median $2,691.53 Typical High $7,943.28 | Facility | None | $323.59 | $2,691.53 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $389.05 Typical High $691.83 | Professional | None | $190.55 | $389.05 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $389.05 Typical High $436.52 | Professional | None | $151.36 | $389.05 | $436.52 |
BCBS Kansas Setting Facility Modifier None Typical Low $1,148.15 Median $2,344.23 Typical High $2,454.71 | Facility | None | $1,148.15 | $2,344.23 | $2,454.71 |
BCBS Kansas Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $724.44 | Professional | None | $371.54 | $371.54 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,258.93 Typical High $1,288.25 | Facility | None | $707.95 | $1,258.93 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $436.52 Typical High $602.56 | Professional | None | $229.09 | $436.52 | $602.56 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $1,737.80 Typical High $39,810.72 | Facility | None | $562.34 | $1,737.80 | $39,810.72 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,659.59 Typical High $3,235.94 | Professional | None | $489.78 | $1,659.59 | $3,235.94 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,737.80 Typical High $4,570.88 | Facility | None | $831.76 | $1,737.80 | $4,570.88 |
United Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $645.65 | Professional | None | $263.03 | $426.58 | $645.65 |
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 $95.50 Median $158.49 Typical High $346.74 | Professional | 52 · Reduced service | $95.50 | $158.49 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $63.10 Typical High $138.04 | Professional | 53 · Discontinued | $38.02 | $63.10 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $234.42 Typical High $512.86 | Professional | 54 · Surgery only | $141.25 | $234.42 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $46.77 Typical High $102.33 | Professional | 55 · Aftercare only | $28.84 | $46.77 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $31.62 Typical High $69.18 | Professional | 56 · Pre-op care only | $19.05 | $31.62 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $218.78 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $131.83 | $218.78 | $478.63 |
Where Kansas sits
The same service costs 4.6 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,728MT $1,029
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.