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 $489.78 Median $2,754.23 Typical High $7,943.28 | Facility | None | $489.78 | $2,754.23 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $134.90 Typical High $288.40 | Professional | None | $66.07 | $134.90 | $288.40 |
BCBS Kansas Setting Facility Modifier None Typical Low $302.00 Median $316.23 Typical High $316.23 | Facility | None | $302.00 | $316.23 | $316.23 |
BCBS Kansas Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $316.23 | Professional | None | $128.82 | $128.82 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $186.21 Typical High $281.84 | Professional | None | $74.13 | $186.21 | $281.84 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $288.40 Typical High $1,288.25 | Facility | None | $54.95 | $288.40 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $794.33 Typical High $2,691.53 | Professional | None | $194.98 | $794.33 | $2,691.53 |
United Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $1,905.46 | Facility | None | $389.05 | $851.14 | $1,905.46 |
United Setting Professional Modifier None Typical Low $72.44 Median $165.96 Typical High $257.04 | Professional | None | $72.44 | $165.96 | $257.04 |
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 $33.11 Median $51.29 Typical High $144.54 | Professional | 52 · Reduced service | $33.11 | $51.29 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $20.89 Typical High $57.54 | Professional | 53 · Discontinued | $13.18 | $20.89 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $77.62 Typical High $213.80 | Professional | 54 · Surgery only | $48.98 | $77.62 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $15.49 Typical High $42.66 | Professional | 55 · Aftercare only | $10.00 | $15.49 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.23 Typical High $28.84 | Professional | 56 · Pre-op care only | $6.61 | $10.23 | $28.84 |
Where Kansas sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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
$229
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.