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 $1,949.84 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,949.84 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $309.03 | Professional | None | $275.42 | $288.40 | $309.03 |
BCBS Kansas Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $489.78 | Facility | None | $478.63 | $478.63 | $489.78 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $954.99 Typical High $4,897.79 | Facility | None | $331.13 | $954.99 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $2,344.23 | Professional | None | $363.08 | $426.58 | $2,344.23 |
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 $346.74 Median $416.87 Typical High $602.56 | Professional | None | $346.74 | $416.87 | $602.56 |
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 $138.04 Median $144.54 Typical High $151.36 | Professional | 52 · Reduced service | $138.04 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $57.54 Typical High $61.66 | Professional | 53 · Discontinued | $54.95 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $213.80 Typical High $229.09 | Professional | 54 · Surgery only | $204.17 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $42.66 Typical High $45.71 | Professional | 55 · Aftercare only | $40.74 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.84 Typical High $30.90 | Professional | 56 · Pre-op care only | $27.54 | $28.84 | $30.90 |
Where Kansas sits
The same service costs 6.3 times more in Texas than in Pennsylvania. 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· 30th of 51
$427
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.