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 $12.59 Median $24.55 Typical High $52.48 | Facility | None | $12.59 | $24.55 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $23.44 Typical High $52.48 | Professional | None | $11.75 | $23.44 | $52.48 |
BCBS Kansas Setting Facility Modifier None Typical Low $64.57 Median $67.61 Typical High $67.61 | Facility | None | $64.57 | $67.61 | $67.61 |
BCBS Kansas Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $39.81 | Professional | None | $14.45 | $14.45 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $446.68 Typical High $2,691.53 | Facility | None | $380.19 | $446.68 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $28.18 Typical High $44.67 | Professional | None | $10.23 | $28.18 | $44.67 |
Medica Setting Facility Modifier None Typical Low $17.38 Median $158.49 Typical High $1,258.93 | Facility | None | $17.38 | $158.49 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $42.66 Typical High $338.84 | Professional | None | $28.84 | $42.66 | $338.84 |
United Setting Facility Modifier None Typical Low $125.89 Median $398.11 Typical High $1,819.70 | Facility | None | $125.89 | $398.11 | $1,819.70 |
United Setting Professional Modifier None Typical Low $10.47 Median $26.92 Typical High $42.66 | Professional | None | $10.47 | $26.92 | $42.66 |
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 $5.89 Median $15.14 Typical High $26.30 | Professional | 52 · Reduced service | $5.89 | $15.14 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $6.03 Typical High $10.47 | Professional | 53 · Discontinued | $2.34 | $6.03 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.71 Median $22.91 Typical High $38.90 | Professional | 54 · Surgery only | $8.71 | $22.91 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $4.57 Typical High $7.94 | Professional | 55 · Aftercare only | $1.78 | $4.57 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $3.02 Typical High $5.25 | Professional | 56 · Pre-op care only | $1.17 | $3.02 | $5.25 |
Where Kansas sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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
$44.67
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.