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 $3,630.78 Median $6,760.83 Typical High $10,232.93 | Professional | None (both parts) | $3,630.78 | $6,760.83 | $10,232.93 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $323.59 Median $478.63 Typical High $489.78 | Professional | 26 · Professional part | $323.59 | $478.63 | $489.78 |
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 $331.13 Median $407.38 Typical High $549.54 | Professional | 26 · Professional part | $331.13 | $407.38 | $549.54 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $2,511.89 Typical High $8,317.64 | Facility | None | $776.25 | $2,511.89 | $8,317.64 |
Medica Setting Professional Modifier None (both parts) Typical Low $338.84 Median $457.09 Typical High $1,862.09 | Professional | None (both parts) | $338.84 | $457.09 | $1,862.09 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $338.84 Median $457.09 Typical High $1,862.09 | Professional | 26 · Professional part | $338.84 | $457.09 | $1,862.09 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,691.53 Typical High $8,709.64 | Facility | None | $870.96 | $2,691.53 | $8,709.64 |
United Setting Professional Modifier None (both parts) Typical Low $316.23 Median $446.68 Typical High $707.95 | Professional | None (both parts) | $316.23 | $446.68 | $707.95 |
United Setting Professional Modifier 26 · Professional part Typical Low $316.23 Median $446.68 Typical High $707.95 | Professional | 26 · Professional part | $316.23 | $446.68 | $707.95 |
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 $158.49 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $158.49 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $95.50 Typical High $97.72 | Professional | 53 · Discontinued | $64.57 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $354.81 Typical High $371.54 | Professional | 54 · Surgery only | $239.88 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $47.86 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $32.36 | $47.86 | $48.98 |
Where Kansas sits
The same service costs 23.4 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· 8th 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.