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 $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $794.33 | Professional | None | $512.86 | $724.44 | $794.33 |
BCBS Setting Facility Modifier None Typical Low $724.44 Median $758.58 Typical High $776.25 | Facility | None | $724.44 | $758.58 | $776.25 |
BCBS Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $758.58 Typical High $4,168.69 | Facility | None | $501.19 | $758.58 | $4,168.69 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $5,011.87 | Professional | None | $309.03 | $501.19 | $5,011.87 |
United Setting Facility Modifier None Typical Low $478.63 Median $524.81 Typical High $1,071.52 | Facility | None | $478.63 | $524.81 | $1,071.52 |
United Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $588.84 | Professional | None | $302.00 | $457.09 | $588.84 |
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 $251.19 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $251.19 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $102.33 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $75.86 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $51.29 | $72.44 | $79.43 |
Where Kansas sits
The same service costs 3.2 times more in Hawaii 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· 11th of 51
$776
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.