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 $43.65 Median $70.79 Typical High $125.89 | Professional | None | $43.65 | $70.79 | $125.89 |
BCBS Kansas Setting Facility Modifier None Typical Low $63.10 Median $346.74 Typical High $371.54 | Facility | None | $63.10 | $346.74 | $371.54 |
BCBS Kansas Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $181.97 | Professional | None | $104.71 | $104.71 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $436.52 Typical High $436.52 | Facility | None | $54.95 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $141.25 Typical High $234.42 | Professional | None | $72.44 | $141.25 | $234.42 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $416.87 Typical High $1,737.80 | Facility | None | $54.95 | $416.87 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $1,023.29 | Professional | None | $85.11 | $169.82 | $1,023.29 |
United Setting Facility Modifier None Typical Low $331.13 Median $691.83 Typical High $2,454.71 | Facility | None | $331.13 | $691.83 | $2,454.71 |
United Setting Professional Modifier None Typical Low $52.48 Median $85.11 Typical High $169.82 | Professional | None | $52.48 | $85.11 | $169.82 |
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 $21.88 Median $34.67 Typical High $63.10 | Professional | 52 · Reduced service | $21.88 | $34.67 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $14.13 Typical High $25.12 | Professional | 53 · Discontinued | $8.71 | $14.13 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $52.48 Typical High $95.50 | Professional | 54 · Surgery only | $32.36 | $52.48 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.47 Typical High $19.05 | Professional | 55 · Aftercare only | $6.46 | $10.47 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $7.08 Typical High $12.59 | Professional | 56 · Pre-op care only | $4.37 | $7.08 | $12.59 |
Where Kansas sits
The same service costs 3.2 times more in Alaska than in Virginia. 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· 8th of 51
$132
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.