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 $2,041.74 Median $5,128.61 Typical High $9,549.93 | Facility | None | $2,041.74 | $5,128.61 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $181.97 | Professional | None | $123.03 | $141.25 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
BCBS Kansas Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
BCBS Kansas Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,398.83 | Facility | None | $912.01 | $2,089.30 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $288.40 | Professional | None | $131.83 | $186.21 | $288.40 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $2,290.87 Typical High $26,302.68 | Facility | None | $194.98 | $2,290.87 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $1,071.52 | Professional | None | $125.89 | $186.21 | $1,071.52 |
United Setting Facility Modifier None Typical Low $691.83 Median $2,187.76 Typical High $6,760.83 | Facility | None | $691.83 | $2,187.76 | $6,760.83 |
United Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $223.87 | Professional | None | $125.89 | $151.36 | $223.87 |
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 $61.66 Median $70.79 Typical High $72.44 | Professional | 52 · Reduced service | $61.66 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $28.18 Typical High $28.84 | Professional | 53 · Discontinued | $24.55 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $107.15 Typical High $109.65 | Professional | 54 · Surgery only | $91.20 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $21.38 Typical High $21.88 | Professional | 55 · Aftercare only | $18.20 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.13 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.30 | $14.13 | $14.45 |
Where Kansas sits
The same service costs 10.7 times more in Oklahoma 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· 16th of 51
$251
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.