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 $9.55 Median $17.38 Typical High $23.99 | Facility | None | $9.55 | $17.38 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $16.60 Typical High $20.89 | Professional | None | $11.75 | $16.60 | $20.89 |
BCBS Kansas Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $39.81 | Professional | None | $30.90 | $30.90 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $7.24 Median $16.98 Typical High $389.05 | Facility | None | $7.24 | $16.98 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $12.59 Median $18.62 Typical High $44.67 | Professional | None | $12.59 | $18.62 | $44.67 |
Medica Setting Facility Modifier None Typical Low $21.88 Median $165.96 Typical High $1,288.25 | Facility | None | $21.88 | $165.96 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $25.70 Typical High $295.12 | Professional | None | $16.98 | $25.70 | $295.12 |
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 $14.13 Median $17.38 Typical High $30.90 | Professional | None | $14.13 | $17.38 | $30.90 |
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 $5.89 Median $8.32 Typical High $10.47 | Professional | 52 · Reduced service | $5.89 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $3.39 Typical High $4.17 | Professional | 53 · Discontinued | $2.34 | $3.39 | $4.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $12.59 Typical High $15.85 | Professional | 54 · Surgery only | $8.91 | $12.59 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $2.51 Typical High $3.16 | Professional | 55 · Aftercare only | $1.78 | $2.51 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.70 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.17 | $1.70 | $2.09 |
Where Kansas sits
The same service costs 3.5 times more in Alaska than in New York. 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· 7th of 51
$26.30
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.