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 $5,128.61 Typical High $9,549.93 | Facility | None | $2,884.03 | $5,128.61 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,479.11 | $2,041.74 | $2,570.40 |
BCBS Kansas Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $4,265.80 Typical High $26,302.68 | Facility | None | $1,348.96 | $4,265.80 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $9,772.37 | Professional | None | $1,348.96 | $1,778.28 | $9,772.37 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $4,073.80 Typical High $8,912.51 | Facility | None | $1,000.00 | $4,073.80 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,584.89 | $1,862.09 |
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 $741.31 Median $1,023.29 Typical High $1,288.25 | Professional | 52 · Reduced service | $741.31 | $1,023.29 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $407.38 Typical High $512.86 | Professional | 53 · Discontinued | $295.12 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,513.56 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,096.48 | $1,513.56 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $302.00 Typical High $389.05 | Professional | 55 · Aftercare only | $218.78 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $204.17 Typical High $257.04 | Professional | 56 · Pre-op care only | $147.91 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,412.54 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,412.54 | $1,819.70 |
Where Kansas sits
The same service costs 8.3 times more in Wyoming 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· 20th of 51
$1,995
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.