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 $1,698.24 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,698.24 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $302.00 | Professional | None | $257.04 | $295.12 | $302.00 |
BCBS Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $2,041.74 | Facility | None | $446.68 | $676.08 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $602.56 | Professional | None | $275.42 | $398.11 | $602.56 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $602.56 Typical High $4,466.84 | Facility | None | $54.95 | $602.56 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $2,691.53 | Professional | None | $269.15 | $354.81 | $2,691.53 |
United Setting Facility Modifier None Typical Low $407.38 Median $1,000.00 Typical High $5,248.07 | Facility | None | $407.38 | $1,000.00 | $5,248.07 |
United Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $478.63 | Professional | None | $269.15 | $309.03 | $478.63 |
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 $128.82 Median $147.91 Typical High $151.36 | Professional | 52 · Reduced service | $128.82 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $58.88 Typical High $60.26 | Professional | 53 · Discontinued | $51.29 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $218.78 Typical High $229.09 | Professional | 54 · Surgery only | $190.55 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $44.67 Typical High $45.71 | Professional | 55 · Aftercare only | $38.02 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $29.51 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.70 | $29.51 | $30.20 |
Where Kansas sits
The same service costs 3.2 times more in Alaska than in Utah. 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
$427
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.