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 $1,348.96 Median $3,162.28 Typical High $7,943.28 | Facility | None | $1,348.96 | $3,162.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $91.20 | Professional | None | $52.48 | $74.13 | $91.20 |
BCBS Kansas Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $181.97 Typical High $676.08 | Facility | None | $165.96 | $181.97 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $77.62 Typical High $123.03 | Professional | None | $39.81 | $77.62 | $123.03 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,380.38 | Facility | None | $54.95 | $331.13 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $23.99 Median $28.84 Typical High $331.13 | Professional | None | $23.99 | $28.84 | $331.13 |
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 $22.91 Median $26.92 Typical High $57.54 | Professional | None | $22.91 | $26.92 | $57.54 |
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 $26.30 Median $37.15 Typical High $45.71 | Professional | 52 · Reduced service | $26.30 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $14.79 Typical High $18.20 | Professional | 53 · Discontinued | $10.47 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $54.95 Typical High $69.18 | Professional | 54 · Surgery only | $38.90 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $11.22 Typical High $13.80 | Professional | 55 · Aftercare only | $7.76 | $11.22 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.41 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.25 | $7.41 | $9.12 |
Where Kansas sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 12th of 51
$145
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.