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 $89.13 Median $128.82 Typical High $190.55 | Professional | None | $89.13 | $128.82 | $190.55 |
BCBS Kansas Setting Facility Modifier None Typical Low $89.13 Median $1,445.44 Typical High $1,548.82 | Facility | None | $89.13 | $1,445.44 | $1,548.82 |
BCBS Kansas Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $194.98 | Professional | None | $151.36 | $151.36 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $93.33 Typical High $389.05 | Facility | None | $83.18 | $93.33 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $223.87 | Professional | None | $93.33 | $134.90 | $223.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $199.53 Typical High $1,380.38 | Facility | None | $54.95 | $199.53 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $269.15 Typical High $1,000.00 | Professional | None | $128.82 | $269.15 | $1,000.00 |
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 $128.82 Typical High $199.53 | Professional | None | $100.00 | $128.82 | $199.53 |
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 $44.67 Median $64.57 Typical High $95.50 | Professional | 52 · Reduced service | $44.67 | $64.57 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $25.70 Typical High $38.02 | Professional | 53 · Discontinued | $17.78 | $25.70 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $97.72 Typical High $144.54 | Professional | 54 · Surgery only | $66.07 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.50 Typical High $28.84 | Professional | 55 · Aftercare only | $13.18 | $19.50 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.88 Typical High $19.05 | Professional | 56 · Pre-op care only | $8.91 | $12.88 | $19.05 |
Where Kansas sits
The same service costs 3.3 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· 10th 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.