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 $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $5,248.07 Median $7,413.10 Typical High $7,585.78 | Professional | None | $5,248.07 | $7,413.10 | $7,585.78 |
BCBS Kansas Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Professional | None | $12,302.69 | $12,302.69 | $12,302.69 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
Medica Setting Facility Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $44,668.36 | Facility | None | $5,248.07 | $7,585.78 | $44,668.36 |
Medica Setting Professional Modifier None Typical Low $4,265.80 Median $6,918.31 Typical High $51,286.14 | Professional | None | $4,265.80 | $6,918.31 | $51,286.14 |
United Setting Professional Modifier None Typical Low $3,388.44 Median $5,011.87 Typical High $7,079.46 | Professional | None | $3,388.44 | $5,011.87 | $7,079.46 |
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 $2,630.27 Median $3,715.35 Typical High $3,801.89 | Professional | 52 · Reduced service | $2,630.27 | $3,715.35 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,513.56 Typical High $1,513.56 | Professional | 53 · Discontinued | $1,047.13 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $794.33 Median $1,122.02 Typical High $1,148.15 | Professional | 55 · Aftercare only | $794.33 | $1,122.02 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $741.31 Typical High $758.58 | Professional | 56 · Pre-op care only | $524.81 | $741.31 | $758.58 |
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· 13th of 51
$7,943
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.