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 $1,698.24 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,698.24 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $302.00 | Professional | None | $229.09 | $302.00 | $302.00 |
BCBS Kansas Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $2,041.74 | Facility | None | $446.68 | $602.56 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $338.84 | Professional | None | $204.17 | $281.84 | $338.84 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $588.84 Typical High $4,466.84 | Facility | None | $54.95 | $588.84 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $1,288.25 | Professional | None | $213.80 | $295.12 | $1,288.25 |
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 $204.17 Median $295.12 Typical High $398.11 | Professional | None | $204.17 | $295.12 | $398.11 |
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 $114.82 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $114.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $45.71 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $169.82 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $33.88 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.91 | $30.20 | $30.20 |
Where Kansas sits
The same service costs 4.3 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
$316
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.