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 $42.66 Median $151.36 Typical High $257.04 | Professional | None | $42.66 | $151.36 | $257.04 |
BCBS Kansas Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $204.17 | Professional | None | $54.95 | $54.95 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $107.15 | Facility | None | $66.07 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $162.18 Typical High $234.42 | Professional | None | $43.65 | $162.18 | $234.42 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $416.87 Typical High $1,737.80 | Facility | None | $54.95 | $416.87 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $602.56 Typical High $1,202.26 | Professional | None | $154.88 | $602.56 | $1,202.26 |
United Setting Facility Modifier None Typical Low $331.13 Median $691.83 Typical High $2,454.71 | Facility | None | $331.13 | $691.83 | $2,454.71 |
United Setting Professional Modifier None Typical Low $41.69 Median $100.00 Typical High $186.21 | Professional | None | $41.69 | $100.00 | $186.21 |
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 $20.89 Median $48.98 Typical High $128.82 | Professional | 52 · Reduced service | $20.89 | $48.98 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $19.50 Typical High $51.29 | Professional | 53 · Discontinued | $8.51 | $19.50 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $74.13 Typical High $190.55 | Professional | 54 · Surgery only | $31.62 | $74.13 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $14.79 Typical High $38.90 | Professional | 55 · Aftercare only | $6.31 | $14.79 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $9.77 Typical High $25.70 | Professional | 56 · Pre-op care only | $4.27 | $9.77 | $25.70 |
Where Kansas sits
The same service costs 4.6 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· 7th of 51
$182
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.