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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $120.23 | Professional | None | $77.62 | $109.65 | $120.23 |
BCBS Setting Facility Modifier None Typical Low $74.13 Median $77.62 Typical High $77.62 | Facility | None | $74.13 | $77.62 | $77.62 |
BCBS Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $114.82 Typical High $707.95 | Facility | None | $75.86 | $114.82 | $707.95 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $831.76 | Professional | None | $53.70 | $79.43 | $831.76 |
United Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $190.55 | Facility | None | $39.81 | $69.18 | $190.55 |
United Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $93.33 | Professional | None | $46.77 | $69.18 | $93.33 |
4 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 $38.02 Median $54.95 Typical High $60.26 | Professional | 52 · Reduced service | $38.02 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $21.88 Typical High $23.99 | Professional | 53 · Discontinued | $15.49 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $11.48 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.96 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.76 | $10.96 | $12.02 |
Where Kansas sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 28th of 51
$89.13
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.