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 $91.20 Median $309.03 Typical High $524.81 | Professional | None | $91.20 | $309.03 | $524.81 |
BCBS Kansas Setting Facility Modifier None Typical Low $158.49 Median $436.52 Typical High $467.74 | Facility | None | $158.49 | $436.52 | $467.74 |
BCBS Kansas Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $478.63 | Professional | None | $125.89 | $125.89 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $177.83 Typical High $676.08 | Facility | None | $165.96 | $177.83 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $346.74 Typical High $478.63 | Professional | None | $91.20 | $346.74 | $478.63 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $371.54 Typical High $1,380.38 | Facility | None | $54.95 | $371.54 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $1,174.90 Typical High $2,454.71 | Professional | None | $398.11 | $1,174.90 | $2,454.71 |
United Setting Facility Modifier None Typical Low $125.89 Median $398.11 Typical High $1,778.28 | Facility | None | $125.89 | $398.11 | $1,778.28 |
United Setting Professional Modifier None Typical Low $100.00 Median $295.12 Typical High $446.68 | Professional | None | $100.00 | $295.12 | $446.68 |
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 $138.04 Typical High $263.03 | Professional | 52 · Reduced service | $45.71 | $138.04 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $54.95 Typical High $104.71 | Professional | 53 · Discontinued | $18.20 | $54.95 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $208.93 Typical High $398.11 | Professional | 54 · Surgery only | $69.18 | $208.93 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $41.69 Typical High $79.43 | Professional | 55 · Aftercare only | $13.80 | $41.69 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $27.54 Typical High $52.48 | Professional | 56 · Pre-op care only | $9.12 | $27.54 | $52.48 |
Where Kansas sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 5th of 51
$398
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.