How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $173.78 Median $173.78 Typical High $181.97 | Facility | None | $173.78 | $173.78 | $181.97 |
Aetna Setting Professional Modifier None (both parts) Typical Low $83.18 Median $104.71 Typical High $181.97 | Professional | None (both parts) | $83.18 | $104.71 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $52.48 Typical High $91.20 | Professional | 52 · Reduced service | $40.74 | $52.48 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $20.89 Typical High $36.31 | Professional | 53 · Discontinued | $16.60 | $20.89 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.85 Typical High $26.92 | Professional | 55 · Aftercare only | $12.30 | $15.85 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.47 Typical High $18.20 | Professional | 56 · Pre-op care only | $8.32 | $10.47 | $18.20 |
BCBS Kansas Setting Professional Modifier None (both parts) Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None (both parts) | $131.83 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $912.01 Typical High $1,737.80 | Facility | None | $524.81 | $912.01 | $1,737.80 |
Cigna Setting Professional Modifier None (both parts) Typical Low $102.33 Median $147.91 Typical High $147.91 | Professional | None (both parts) | $102.33 | $147.91 | $147.91 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $194.98 | Facility | None | $120.23 | $120.23 | $194.98 |
Medica Setting Professional Modifier None (both parts) Typical Low $100.00 Median $158.49 Typical High $537.03 | Professional | None (both parts) | $100.00 | $158.49 | $537.03 |
United Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $691.83 | Facility | None | $436.52 | $436.52 | $691.83 |
United Setting Professional Modifier None (both parts) Typical Low $93.33 Median $120.23 Typical High $186.21 | Professional | None (both parts) | $93.33 | $120.23 | $186.21 |
2 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 |
|---|---|---|---|---|---|
Cigna Setting Professional Modifier TC · Technical part Typical Low $102.33 Median $102.33 Typical High $194.98 | Professional | TC · Technical part | $102.33 | $102.33 | $194.98 |
Medica Setting Professional Modifier TC · Technical part Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | TC · Technical part | $467.74 | $467.74 | $467.74 |
Where Kansas sits
The same service costs 2.9 times more in Alaska than in Florida. 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· 12th 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.