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 $1,949.84 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,949.84 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,230.27 | Professional | None | $912.01 | $1,202.26 | $1,230.27 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $676.08 Typical High $2,041.74 | Facility | None | $380.19 | $676.08 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,380.38 | Professional | None | $831.76 | $1,071.52 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $977.24 Typical High $4,466.84 | Facility | None | $54.95 | $977.24 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $5,248.07 | Professional | None | $851.14 | $1,174.90 | $5,248.07 |
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 $812.83 Median $1,174.90 Typical High $1,621.81 | Professional | None | $812.83 | $1,174.90 | $1,621.81 |
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 $457.09 Median $602.56 Typical High $616.60 | Professional | 52 · Reduced service | $457.09 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $181.97 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $676.08 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $138.04 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $120.23 Typical High $123.03 | Professional | 56 · Pre-op care only | $91.20 | $120.23 | $123.03 |
Where Kansas sits
The same service costs 3.8 times more in Wisconsin 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· 27th of 51
$1,096
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.