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 $48.98 Median $2,754.23 Typical High $7,943.28 | Facility | None | $48.98 | $2,754.23 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $41.69 Typical High $69.18 | Professional | None | $24.55 | $41.69 | $69.18 |
BCBS Setting Facility Modifier None Typical Low $66.07 Median $69.18 Typical High $72.44 | Facility | None | $66.07 | $69.18 | $72.44 |
BCBS Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $64.57 | Professional | None | $36.31 | $36.31 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $57.54 | Facility | None | $25.70 | $25.70 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $45.71 Typical High $61.66 | Professional | None | $25.70 | $45.71 | $61.66 |
Medica Setting Facility Modifier None Typical Low $44.67 Median $162.18 Typical High $1,288.25 | Facility | None | $44.67 | $162.18 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $338.84 | Professional | None | $44.67 | $52.48 | $338.84 |
United Setting Facility Modifier None Typical Low $114.82 Median $398.11 Typical High $1,778.28 | Facility | None | $114.82 | $398.11 | $1,778.28 |
United Setting Professional Modifier None Typical Low $26.30 Median $44.67 Typical High $60.26 | Professional | None | $26.30 | $44.67 | $60.26 |
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 $12.30 Median $18.62 Typical High $34.67 | Professional | 52 · Reduced service | $12.30 | $18.62 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $7.59 Typical High $13.80 | Professional | 53 · Discontinued | $4.90 | $7.59 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $28.18 Typical High $52.48 | Professional | 54 · Surgery only | $18.62 | $28.18 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $5.62 Typical High $10.47 | Professional | 55 · Aftercare only | $3.72 | $5.62 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.80 Typical High $6.92 | Professional | 56 · Pre-op care only | $2.45 | $3.80 | $6.92 |
Where Kansas sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 9th of 51
$61.66
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.