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 $954.99 Median $3,162.28 Typical High $7,943.28 | Facility | None | $954.99 | $3,162.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $251.19 | Professional | None | $114.82 | $158.49 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | None | $100.00 | $112.20 | $112.20 |
BCBS Kansas Setting Facility Modifier None Typical Low $95.50 Median $776.25 Typical High $812.83 | Facility | None | $95.50 | $776.25 | $812.83 |
BCBS Kansas Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $186.21 | Professional | None | $151.36 | $151.36 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $100.00 Typical High $389.05 | Facility | None | $97.72 | $100.00 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $177.83 | Professional | None | $104.71 | $128.82 | $177.83 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $380.19 Typical High $11,481.54 | Facility | None | $144.54 | $380.19 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $758.58 Typical High $954.99 | Professional | None | $131.83 | $758.58 | $954.99 |
United Setting Facility Modifier None Typical Low $125.89 Median $398.11 Typical High $1,778.28 | Facility | None | $125.89 | $398.11 | $1,778.28 |
United Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $173.78 | Professional | None | $107.15 | $138.04 | $173.78 |
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 $57.54 Median $79.43 Typical High $125.89 | Professional | 52 · Reduced service | $57.54 | $79.43 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $31.62 Typical High $50.12 | Professional | 53 · Discontinued | $22.91 | $31.62 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $117.49 Typical High $190.55 | Professional | 54 · Surgery only | $85.11 | $117.49 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $23.44 Typical High $38.02 | Professional | 55 · Aftercare only | $17.38 | $23.44 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.85 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.48 | $15.85 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $109.65 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $79.43 | $109.65 | $177.83 |
Where Kansas sits
The same service costs 4.0 times more in Alaska than in Florida. 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
$186
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.