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 $1,348.96 Median $3,162.28 Typical High $7,943.28 | Facility | None | $1,348.96 | $3,162.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,071.52 | Professional | None | $616.60 | $851.14 | $1,071.52 |
BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,412.54 | $1,479.11 | $1,479.11 |
BCBS Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $1,548.82 Typical High $1,698.24 | Facility | None | $380.19 | $1,548.82 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $758.58 | Professional | None | $537.03 | $724.44 | $758.58 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $1,737.80 Typical High $12,022.64 | Facility | None | $707.95 | $1,737.80 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $4,168.69 | Professional | None | $512.86 | $724.44 | $4,168.69 |
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 $489.78 Median $645.65 Typical High $776.25 | Professional | None | $489.78 | $645.65 | $776.25 |
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 $309.03 Median $426.58 Typical High $537.03 | Professional | 52 · Reduced service | $309.03 | $426.58 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $169.82 Typical High $213.80 | Professional | 53 · Discontinued | $123.03 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $630.96 Typical High $812.83 | Professional | 54 · Surgery only | $467.74 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $125.89 Typical High $162.18 | Professional | 55 · Aftercare only | $93.33 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $85.11 Typical High $107.15 | Professional | 56 · Pre-op care only | $61.66 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $588.84 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $436.52 | $588.84 | $758.58 |
Where Kansas sits
The same service costs 8.3 times more in Wyoming than in Texas. 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· 12th of 51
$1,072
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.