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 $954.99 Median $3,162.28 Typical High $7,943.28 | Facility | None | $954.99 | $3,162.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $218.78 Typical High $218.78 | Professional | None | $114.82 | $218.78 | $218.78 |
BCBS Kansas Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $691.83 Typical High $3,801.89 | Facility | None | $54.95 | $691.83 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $190.55 | Professional | None | $120.23 | $141.25 | $190.55 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $2,630.27 Typical High $4,073.80 | Facility | None | $1,023.29 | $2,630.27 | $4,073.80 |
United Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $208.93 | Professional | None | $120.23 | $141.25 | $208.93 |
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 $57.54 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $57.54 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $23.44 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $165.96 Typical High $165.96 | Professional | 54 · Surgery only | $87.10 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $17.38 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $11.48 | $21.88 | $21.88 |
Where Kansas sits
The same service costs 37.2 times more in Oklahoma 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· 32nd of 51
$186
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.