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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $177.83 | Professional | None | $123.03 | $173.78 | $177.83 |
BCBS Setting Facility Modifier None Typical Low $190.55 Median $199.53 Typical High $199.53 | Facility | None | $190.55 | $199.53 | $199.53 |
BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $138.04 | Professional | None | $102.33 | $102.33 | $138.04 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $199.53 Typical High $1,174.90 | Facility | None | $123.03 | $199.53 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $1,479.11 | Professional | None | $100.00 | $158.49 | $1,479.11 |
United Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $302.00 | Facility | None | $147.91 | $154.88 | $302.00 |
United Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $169.82 | Professional | None | $79.43 | $117.49 | $169.82 |
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 $61.66 Median $87.10 Typical High $89.13 | Professional | 52 · Reduced service | $61.66 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $24.55 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.30 Typical High $26.92 | Professional | 55 · Aftercare only | $18.62 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.38 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.30 | $17.38 | $17.78 |
Where Kansas sits
The same service costs 3.5 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· 15th of 51
$191
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.