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 $173.78 Median $2,754.23 Typical High $7,943.28 | Facility | None | $173.78 | $2,754.23 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $147.91 | Professional | None | $64.57 | $97.72 | $147.91 |
BCBS Setting Facility Modifier None Typical Low $70.79 Median $1,023.29 Typical High $1,096.48 | Facility | None | $70.79 | $1,023.29 | $1,096.48 |
BCBS Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $128.82 | Professional | None | $95.50 | $95.50 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $75.86 Typical High $389.05 | Facility | None | $66.07 | $75.86 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $165.96 | Professional | None | $69.18 | $102.33 | $165.96 |
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 $100.00 Median $204.17 Typical High $776.25 | Professional | None | $100.00 | $204.17 | $776.25 |
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 $72.44 Median $100.00 Typical High $144.54 | Professional | None | $72.44 | $100.00 | $144.54 |
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 $32.36 Median $46.77 Typical High $74.13 | Professional | 52 · Reduced service | $32.36 | $46.77 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $19.05 Typical High $29.51 | Professional | 53 · Discontinued | $12.88 | $19.05 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $70.79 Typical High $109.65 | Professional | 54 · Surgery only | $48.98 | $70.79 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $14.13 Typical High $21.88 | Professional | 55 · Aftercare only | $9.77 | $14.13 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.33 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.46 | $9.33 | $14.79 |
Where Kansas sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 17th of 51
$129
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.