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 $109.65 Median $2,754.23 Typical High $7,943.28 | Facility | None | $109.65 | $2,754.23 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $51.29 Typical High $109.65 | Professional | None | $19.05 | $51.29 | $109.65 |
BCBS Kansas Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $251.19 | Facility | None | $234.42 | $234.42 | $251.19 |
BCBS Kansas Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $89.13 | Professional | None | $30.20 | $30.20 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $57.54 | Facility | None | $40.74 | $40.74 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $66.07 Typical High $114.82 | Professional | None | $23.44 | $66.07 | $114.82 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $186.21 Typical High $1,288.25 | Facility | None | $50.12 | $186.21 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $616.60 | Professional | None | $58.88 | $81.28 | $616.60 |
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 $24.55 Median $56.23 Typical High $97.72 | Professional | None | $24.55 | $56.23 | $97.72 |
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 $9.55 Median $15.14 Typical High $54.95 | Professional | 52 · Reduced service | $9.55 | $15.14 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $6.17 Typical High $21.88 | Professional | 53 · Discontinued | $3.89 | $6.17 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $22.91 Typical High $81.28 | Professional | 54 · Surgery only | $14.45 | $22.91 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $4.57 Typical High $16.22 | Professional | 55 · Aftercare only | $2.88 | $4.57 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $3.09 Typical High $10.96 | Professional | 56 · Pre-op care only | $1.91 | $3.09 | $10.96 |
Where Kansas sits
The same service costs 3.4 times more in Wisconsin than in Kentucky. 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· 6th of 51
$89.13
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.