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 $288.40 Median $426.58 Typical High $436.52 | Professional | 26 · Professional part | $288.40 | $426.58 | $436.52 |
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 $6,918.31 Median $9,549.93 Typical High $13,182.57 | Facility | None | $6,918.31 | $9,549.93 | $13,182.57 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $295.12 Median $363.08 Typical High $489.78 | Professional | 26 · Professional part | $295.12 | $363.08 | $489.78 |
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 $309.03 Median $407.38 Typical High $1,659.59 | Professional | None (both parts) | $309.03 | $407.38 | $1,659.59 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $309.03 Median $407.38 Typical High $1,659.59 | Professional | 26 · Professional part | $309.03 | $407.38 | $1,659.59 |
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 $288.40 Median $398.11 Typical High $630.96 | Professional | None (both parts) | $288.40 | $398.11 | $630.96 |
United Setting Professional Modifier 26 · Professional part Typical Low $288.40 Median $398.11 Typical High $630.96 | Professional | 26 · Professional part | $288.40 | $398.11 | $630.96 |
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 $144.54 Median $213.80 Typical High $218.78 | Professional | 52 · Reduced service | $144.54 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $85.11 Typical High $87.10 | Professional | 53 · Discontinued | $57.54 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $323.59 Typical High $331.13 | Professional | 54 · Surgery only | $213.80 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $64.57 Typical High $66.07 | Professional | 55 · Aftercare only | $42.66 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $42.66 Typical High $43.65 | Professional | 56 · Pre-op care only | $28.84 | $42.66 | $43.65 |
Where Kansas sits
The same service costs 19.5 times more in Colorado than in Maryland. 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· 9th 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.