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 $7,943.28 Typical High $16,218.10 | Facility | None | $3,162.28 | $7,943.28 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $10,232.93 Typical High $10,232.93 | Professional | None | $676.08 | $10,232.93 | $10,232.93 |
BCBS Kansas Setting Facility Modifier None Typical Low $8,912.51 Median $18,197.01 Typical High $19,054.61 | Facility | None | $8,912.51 | $18,197.01 | $19,054.61 |
Cigna Setting Facility Modifier None Typical Low $8,128.31 Median $10,000.00 Typical High $11,748.98 | Facility | None | $8,128.31 | $10,000.00 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $5,888.44 Typical High $16,982.44 | Facility | None | $1,000.00 | $5,888.44 | $16,982.44 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $6,165.95 Typical High $13,803.84 | Facility | None | $1,122.02 | $6,165.95 | $13,803.84 |
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 $338.84 Median $5,128.61 Typical High $5,128.61 | Professional | 52 · Reduced service | $338.84 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $2,041.74 Typical High $2,041.74 | Professional | 53 · Discontinued | $134.90 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $7,762.47 Typical High $7,762.47 | Professional | 54 · Surgery only | $501.19 | $7,762.47 | $7,762.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $1,548.82 Typical High $1,548.82 | Professional | 55 · Aftercare only | $100.00 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $1,023.29 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $67.61 | $1,023.29 | $1,023.29 |
Where Kansas sits
The same service costs 281.8 times more in Minnesota than in Montana. 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· 11th of 51
$10,233
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.