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 $56.23 Median $141.25 Typical High $316.23 | Professional | None | $56.23 | $141.25 | $316.23 |
BCBS Kansas Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $239.88 | Professional | None | $100.00 | $100.00 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $489.78 Typical High $660.69 | Facility | None | $194.98 | $489.78 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $177.83 Typical High $501.19 | Professional | None | $75.86 | $177.83 | $501.19 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $194.98 Typical High $288.40 | Facility | None | $89.13 | $194.98 | $288.40 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $1,230.27 | Professional | None | $169.82 | $218.78 | $1,230.27 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $371.54 | Facility | None | $234.42 | $234.42 | $371.54 |
United Setting Professional Modifier None Typical Low $75.86 Median $162.18 Typical High $251.19 | Professional | None | $75.86 | $162.18 | $251.19 |
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 $28.18 Median $61.66 Typical High $158.49 | Professional | 52 · Reduced service | $28.18 | $61.66 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $24.55 Typical High $63.10 | Professional | 53 · Discontinued | $11.48 | $24.55 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $93.33 Typical High $234.42 | Professional | 54 · Surgery only | $42.66 | $93.33 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $18.62 Typical High $46.77 | Professional | 55 · Aftercare only | $8.51 | $18.62 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $12.30 Typical High $31.62 | Professional | 56 · Pre-op care only | $5.62 | $12.30 | $31.62 |
Where Kansas sits
The same service costs 3.5 times more in Alaska 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· 12th of 51
$182
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.