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 $85.11 Median $2,511.89 Typical High $7,943.28 | Facility | None | $85.11 | $2,511.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $125.89 Typical High $239.88 | Professional | None | $50.12 | $125.89 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $40.74 | Professional | None | $38.90 | $39.81 | $40.74 |
BCBS Kansas Setting Facility Modifier None Typical Low $295.12 Median $309.03 Typical High $309.03 | Facility | None | $295.12 | $309.03 | $309.03 |
BCBS Kansas Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $245.47 | Professional | None | $81.28 | $81.28 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $165.96 Typical High $257.04 | Professional | None | $54.95 | $165.96 | $257.04 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $245.47 Typical High $1,258.93 | Facility | None | $54.95 | $245.47 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $602.56 Typical High $1,778.28 | Professional | None | $173.78 | $602.56 | $1,778.28 |
United Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $1,905.46 | Facility | None | $389.05 | $851.14 | $1,905.46 |
United Setting Professional Modifier None Typical Low $56.23 Median $141.25 Typical High $218.78 | Professional | None | $56.23 | $141.25 | $218.78 |
5 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 $24.55 Median $38.90 Typical High $120.23 | Professional | 52 · Reduced service | $24.55 | $38.90 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $15.49 Typical High $47.86 | Professional | 53 · Discontinued | $10.00 | $15.49 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $58.88 Typical High $181.97 | Professional | 54 · Surgery only | $37.15 | $58.88 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $11.75 Typical High $36.31 | Professional | 55 · Aftercare only | $7.41 | $11.75 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.76 Typical High $23.99 | Professional | 56 · Pre-op care only | $5.01 | $7.76 | $23.99 |
Where Kansas sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 7th of 51
$195
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.