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 $724.44 Median $3,630.78 Typical High $7,943.28 | Facility | None | $724.44 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $645.65 | Professional | None | $338.84 | $457.09 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $331.13 Typical High $478.63 | Professional | 54 · Surgery only | $239.88 | $331.13 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $316.23 | Professional | None | $165.96 | $208.93 | $316.23 |
BCBS Kansas Setting Facility Modifier None Typical Low $380.19 Median $870.96 Typical High $912.01 | Facility | None | $380.19 | $870.96 | $912.01 |
BCBS Kansas Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $616.60 | Professional | None | $501.19 | $501.19 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $602.56 | Facility | None | $363.08 | $588.84 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $489.78 | Professional | None | $316.23 | $346.74 | $489.78 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $645.65 Typical High $16,218.10 | Facility | None | $363.08 | $645.65 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $2,344.23 Typical High $2,511.89 | Professional | None | $323.59 | $2,344.23 | $2,511.89 |
United Setting Facility Modifier None Typical Low $331.13 Median $676.08 Typical High $2,454.71 | Facility | None | $331.13 | $676.08 | $2,454.71 |
United Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $457.09 | Professional | None | $295.12 | $371.54 | $457.09 |
5 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 $173.78 Median $234.42 Typical High $323.59 | Professional | 52 · Reduced service | $173.78 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $95.50 Typical High $128.82 | Professional | 53 · Discontinued | $69.18 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $70.79 Typical High $97.72 | Professional | 55 · Aftercare only | $51.29 | $70.79 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $46.77 Typical High $64.57 | Professional | 56 · Pre-op care only | $34.67 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $331.13 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $239.88 | $331.13 | $446.68 |
Where Kansas sits
The same service costs 5.8 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· 13th of 51
$501
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.