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 $51.29 Median $67.61 Typical High $67.61 | Professional | None | $51.29 | $67.61 | $67.61 |
BCBS Kansas Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $57.54 | Facility | None | $16.98 | $16.98 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $72.44 | Professional | None | $43.65 | $58.88 | $72.44 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $371.54 Typical High $1,380.38 | Facility | None | $69.18 | $371.54 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $63.10 Typical High $912.01 | Professional | None | $42.66 | $63.10 | $912.01 |
United Setting Facility Modifier None Typical Low $125.89 Median $407.38 Typical High $1,778.28 | Facility | None | $125.89 | $407.38 | $1,778.28 |
United Setting Professional Modifier None Typical Low $40.74 Median $63.10 Typical High $89.13 | Professional | None | $40.74 | $63.10 | $89.13 |
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 $25.12 Median $33.11 Typical High $33.88 | Professional | 52 · Reduced service | $25.12 | $33.11 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $10.23 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $50.12 Typical High $50.12 | Professional | 54 · Surgery only | $38.02 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $7.59 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.61 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.13 | $6.61 | $6.76 |
Where Kansas sits
The same service costs 9.3 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· 20th of 51
$72.44
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.