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 $131.83 Median $4,677.35 Typical High $9,549.93 | Facility | None | $131.83 | $4,677.35 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $81.28 Typical High $131.83 | Professional | None | $56.23 | $81.28 | $131.83 |
BCBS Kansas Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
BCBS Kansas Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $134.90 | Professional | None | $93.33 | $93.33 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $389.05 | Facility | None | $60.26 | $63.10 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $151.36 | Professional | None | $58.88 | $97.72 | $151.36 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $186.21 Typical High $1,288.25 | Facility | None | $54.95 | $186.21 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $190.55 Typical High $676.08 | Professional | None | $97.72 | $190.55 | $676.08 |
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 $66.07 Median $95.50 Typical High $134.90 | Professional | None | $66.07 | $95.50 | $134.90 |
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 $28.18 Median $40.74 Typical High $64.57 | Professional | 52 · Reduced service | $28.18 | $40.74 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $16.60 Typical High $26.30 | Professional | 53 · Discontinued | $11.22 | $16.60 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $61.66 Typical High $97.72 | Professional | 54 · Surgery only | $41.69 | $61.66 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.30 Typical High $19.50 | Professional | 55 · Aftercare only | $8.51 | $12.30 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.13 Typical High $13.18 | Professional | 56 · Pre-op care only | $5.62 | $8.13 | $13.18 |
Where Kansas sits
The same service costs 3.1 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· 24th of 51
$105
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.