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 $1,348.96 Median $3,162.28 Typical High $7,943.28 | Facility | None | $1,348.96 | $3,162.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $128.82 | Professional | None | $79.43 | $104.71 | $128.82 |
BCBS Kansas Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $2,041.74 | Facility | None | $446.68 | $645.65 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $194.98 | Professional | None | $77.62 | $120.23 | $194.98 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $575.44 Typical High $4,466.84 | Facility | None | $54.95 | $575.44 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $616.60 | Professional | None | $91.20 | $117.49 | $616.60 |
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 $81.28 Median $104.71 Typical High $147.91 | Professional | None | $81.28 | $104.71 | $147.91 |
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 $39.81 Median $52.48 Typical High $64.57 | Professional | 52 · Reduced service | $39.81 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.89 Typical High $25.70 | Professional | 53 · Discontinued | $15.85 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $77.62 Typical High $97.72 | Professional | 54 · Surgery only | $58.88 | $77.62 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $15.85 Typical High $19.50 | Professional | 55 · Aftercare only | $11.75 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.47 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.94 | $10.47 | $12.88 |
Where Kansas sits
The same service costs 6.5 times more in Tennessee than in New York. 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· 13th of 51
$166
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.