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 $30.90 Median $41.69 Typical High $57.54 | Professional | None | $30.90 | $41.69 | $57.54 |
BCBS Kansas Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $50.12 | Professional | None | $47.86 | $47.86 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $446.68 | Facility | None | $12.02 | $12.02 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $32.36 Typical High $43.65 | Professional | None | $28.18 | $32.36 | $43.65 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $162.18 Typical High $1,258.93 | Facility | None | $45.71 | $162.18 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $512.86 Typical High $794.33 | Professional | None | $31.62 | $512.86 | $794.33 |
United Setting Facility Modifier None Typical Low $125.89 Median $398.11 Typical High $1,819.70 | Facility | None | $125.89 | $398.11 | $1,819.70 |
United Setting Professional Modifier None Typical Low $28.84 Median $34.67 Typical High $41.69 | Professional | None | $28.84 | $34.67 | $41.69 |
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 $15.14 Median $20.89 Typical High $28.84 | Professional | 52 · Reduced service | $15.14 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $8.32 Typical High $11.48 | Professional | 53 · Discontinued | $6.17 | $8.32 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $31.62 Typical High $42.66 | Professional | 54 · Surgery only | $22.91 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $6.31 Typical High $8.71 | Professional | 55 · Aftercare only | $4.57 | $6.31 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.17 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.09 | $4.17 | $5.75 |
Where Kansas sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 11th of 51
$47.86
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.