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 $489.78 Median $2,754.23 Typical High $7,943.28 | Facility | None | $489.78 | $2,754.23 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $186.21 Typical High $288.40 | Professional | None | $91.20 | $186.21 | $288.40 |
BCBS Kansas Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $288.40 | Professional | None | $107.15 | $107.15 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $208.93 Typical High $302.00 | Professional | None | $81.28 | $208.93 | $302.00 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $316.23 Typical High $1,288.25 | Facility | None | $54.95 | $316.23 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $660.69 Typical High $1,258.93 | Professional | None | $263.03 | $660.69 | $1,258.93 |
United Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $1,905.46 | Facility | None | $389.05 | $851.14 | $1,905.46 |
United Setting Professional Modifier None Typical Low $83.18 Median $173.78 Typical High $302.00 | Professional | None | $83.18 | $173.78 | $302.00 |
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 $45.71 Median $58.88 Typical High $141.25 | Professional | 52 · Reduced service | $45.71 | $58.88 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $23.44 Typical High $57.54 | Professional | 53 · Discontinued | $18.20 | $23.44 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $89.13 Typical High $213.80 | Professional | 54 · Surgery only | $67.61 | $89.13 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $17.78 Typical High $42.66 | Professional | 55 · Aftercare only | $13.49 | $17.78 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.75 Typical High $28.18 | Professional | 56 · Pre-op care only | $9.12 | $11.75 | $28.18 |
Where Kansas sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 4th of 51
$282
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.