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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $316.23 | Professional | None | $218.78 | $309.03 | $316.23 |
BCBS Kansas Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $354.81 Typical High $2,187.76 | Facility | None | $218.78 | $354.81 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $2,818.38 | Professional | None | $177.83 | $281.84 | $2,818.38 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $323.59 | Professional | None | $141.25 | $208.93 | $323.59 |
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 $109.65 Median $154.88 Typical High $158.49 | Professional | 52 · Reduced service | $109.65 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $61.66 Typical High $63.10 | Professional | 53 · Discontinued | $43.65 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $33.11 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $30.90 Typical High $31.62 | Professional | 56 · Pre-op care only | $21.88 | $30.90 | $31.62 |
Where Kansas sits
The same service costs 3.4 times more in Montana than in New York. 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
$355
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.