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 $3,162.28 Median $8,317.64 Typical High $16,595.87 | Facility | None | $3,162.28 | $8,317.64 | $16,595.87 |
Aetna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $3,630.78 Typical High $10,232.93 | Professional | None (both parts) | $177.83 | $3,630.78 | $10,232.93 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $309.03 Typical High $316.23 | Professional | 26 · Professional part | $208.93 | $309.03 | $316.23 |
BCBS Kansas Setting Facility Modifier None Typical Low $3,019.95 Median $3,090.30 Typical High $3,162.28 | Facility | None | $3,019.95 | $3,090.30 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $6,760.83 Median $9,332.54 Typical High $13,182.57 | Facility | None | $6,760.83 | $9,332.54 | $13,182.57 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $257.04 Typical High $346.74 | Professional | 26 · Professional part | $208.93 | $257.04 | $346.74 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $5,011.87 Typical High $12,589.25 | Facility | None | $977.24 | $5,011.87 | $12,589.25 |
Medica Setting Professional Modifier None (both parts) Typical Low $213.80 Median $288.40 Typical High $1,174.90 | Professional | None (both parts) | $213.80 | $288.40 | $1,174.90 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $213.80 Median $288.40 Typical High $1,174.90 | Professional | 26 · Professional part | $213.80 | $288.40 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $5,888.44 Typical High $13,803.84 | Facility | None | $1,122.02 | $5,888.44 | $13,803.84 |
United Setting Professional Modifier None (both parts) Typical Low $204.17 Median $281.84 Typical High $457.09 | Professional | None (both parts) | $204.17 | $281.84 | $457.09 |
United Setting Professional Modifier 26 · Professional part Typical Low $204.17 Median $281.84 Typical High $457.09 | Professional | 26 · Professional part | $204.17 | $281.84 | $457.09 |
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 $154.88 Typical High $158.49 | Professional | 52 · Reduced service | $104.71 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $61.66 Typical High $64.57 | Professional | 53 · Discontinued | $41.69 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $234.42 Typical High $239.88 | Professional | 54 · Surgery only | $154.88 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $46.77 Typical High $47.86 | Professional | 55 · Aftercare only | $31.62 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $30.90 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.89 | $30.90 | $31.62 |
Where Kansas sits
The same service costs 28.8 times more in Colorado than in Kentucky. 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· 14th of 51
$3,020
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.