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 $3,630.78 Typical High $7,943.28 | Facility | None | $1,698.24 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $741.31 | Professional | None | $416.87 | $575.44 | $741.31 |
BCBS Kansas Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
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 $389.05 Median $524.81 Typical High $549.54 | Professional | None | $389.05 | $524.81 | $549.54 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $691.83 Typical High $4,466.84 | Facility | None | $54.95 | $691.83 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $2,818.38 | Professional | None | $371.54 | $512.86 | $2,818.38 |
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 $354.81 Median $457.09 Typical High $537.03 | Professional | None | $354.81 | $457.09 | $537.03 |
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 $208.93 Median $288.40 Typical High $371.54 | Professional | 52 · Reduced service | $208.93 | $288.40 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $114.82 Typical High $147.91 | Professional | 53 · Discontinued | $85.11 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $436.52 Typical High $549.54 | Professional | 54 · Surgery only | $316.23 | $436.52 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $87.10 Typical High $109.65 | Professional | 55 · Aftercare only | $63.10 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $57.54 Typical High $74.13 | Professional | 56 · Pre-op care only | $41.69 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $407.38 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $295.12 | $407.38 | $512.86 |
Where Kansas sits
The same service costs 6.9 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· 22nd of 51
$513
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.