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 $208.93 Median $295.12 Typical High $371.54 | Professional | None | $208.93 | $295.12 | $371.54 |
BCBS Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
BCBS Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $380.19 | Professional | None | $323.59 | $323.59 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $446.68 | Facility | None | $199.53 | $436.52 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $501.19 | Professional | None | $218.78 | $302.00 | $501.19 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $416.87 Typical High $12,022.64 | Facility | None | $162.18 | $416.87 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $3,090.30 | Professional | None | $269.15 | $302.00 | $3,090.30 |
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 $234.42 Median $281.84 Typical High $426.58 | Professional | None | $234.42 | $281.84 | $426.58 |
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 $104.71 Median $147.91 Typical High $186.21 | Professional | 52 · Reduced service | $104.71 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $58.88 Typical High $74.13 | Professional | 53 · Discontinued | $41.69 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $223.87 Typical High $275.42 | Professional | 54 · Surgery only | $154.88 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $44.67 Typical High $54.95 | Professional | 55 · Aftercare only | $30.90 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $29.51 Typical High $37.15 | Professional | 56 · Pre-op care only | $20.89 | $29.51 | $37.15 |
Where Kansas sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 23rd of 51
$324
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.