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 $45.71 Median $2,511.89 Typical High $7,943.28 | Facility | None | $45.71 | $2,511.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $48.98 Typical High $70.79 | Professional | None | $29.51 | $48.98 | $70.79 |
BCBS Kansas Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $144.54 | Facility | None | $138.04 | $138.04 | $144.54 |
BCBS Kansas Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $70.79 | Professional | None | $37.15 | $37.15 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $57.54 | Facility | None | $34.67 | $34.67 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $48.98 Typical High $123.03 | Professional | None | $28.84 | $48.98 | $123.03 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $162.18 Typical High $1,288.25 | Facility | None | $51.29 | $162.18 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $48.98 Median $97.72 Typical High $426.58 | Professional | None | $48.98 | $97.72 | $426.58 |
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 $29.51 Median $47.86 Typical High $91.20 | Professional | None | $29.51 | $47.86 | $91.20 |
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 $14.79 Median $20.42 Typical High $35.48 | Professional | 52 · Reduced service | $14.79 | $20.42 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $8.13 Typical High $14.13 | Professional | 53 · Discontinued | $5.89 | $8.13 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $30.90 Typical High $52.48 | Professional | 54 · Surgery only | $21.88 | $30.90 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $6.17 Typical High $10.72 | Professional | 55 · Aftercare only | $4.37 | $6.17 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $4.07 Typical High $7.08 | Professional | 56 · Pre-op care only | $2.95 | $4.07 | $7.08 |
Where Kansas sits
The same service costs 3.4 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· 11th of 51
$70.79
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.