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 $204.17 Median $3,467.37 Typical High $7,943.28 | Facility | None | $204.17 | $3,467.37 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $213.80 | Professional | None | $81.28 | $134.90 | $213.80 |
BCBS Kansas Setting Facility Modifier None Typical Low $112.20 Median $4,265.80 Typical High $4,466.84 | Facility | None | $112.20 | $4,265.80 | $4,466.84 |
BCBS Kansas Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $251.19 | Professional | None | $162.18 | $162.18 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $707.95 Typical High $1,148.15 | Facility | None | $112.20 | $707.95 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $223.87 | Professional | None | $97.72 | $154.88 | $223.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $741.31 Typical High $3,388.44 | Facility | None | $54.95 | $741.31 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $3,630.78 | Professional | None | $158.49 | $208.93 | $3,630.78 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,023.29 Typical High $3,311.31 | Facility | None | $501.19 | $1,023.29 | $3,311.31 |
United Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $229.09 | Professional | None | $100.00 | $158.49 | $229.09 |
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 $40.74 Median $64.57 Typical High $107.15 | Professional | 52 · Reduced service | $40.74 | $64.57 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $25.70 Typical High $42.66 | Professional | 53 · Discontinued | $16.22 | $25.70 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $95.50 Typical High $162.18 | Professional | 54 · Surgery only | $60.26 | $95.50 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.05 Typical High $32.36 | Professional | 55 · Aftercare only | $12.30 | $19.05 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.88 Typical High $21.38 | Professional | 56 · Pre-op care only | $8.13 | $12.88 | $21.38 |
Where Kansas sits
The same service costs 3.2 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· 10th of 51
$214
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.