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 $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $501.19 | Professional | None | $346.74 | $489.78 | $501.19 |
BCBS Kansas Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Facility | None | $691.83 | $691.83 | $724.44 |
BCBS Kansas Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $346.74 Median $562.34 Typical High $2,884.03 | Facility | None | $346.74 | $562.34 | $2,884.03 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $3,311.31 | Professional | None | $281.84 | $446.68 | $3,311.31 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $457.09 | Professional | None | $223.87 | $331.13 | $457.09 |
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 $173.78 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $173.78 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $69.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $74.13 Typical High $75.86 | Professional | 55 · Aftercare only | $52.48 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $34.67 | $48.98 | $50.12 |
Where Kansas sits
The same service costs 2.6 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· 2nd of 51
$692
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.