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 $83.18 Median $83.18 Typical High $93.33 | Facility | None | $83.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $53.70 Typical High $83.18 | Professional | None | $44.67 | $53.70 | $83.18 |
BCBS Kansas Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $446.68 | Facility | None | $323.59 | $323.59 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $100.00 | Professional | None | $48.98 | $67.61 | $100.00 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $302.00 Typical High $1,288.25 | Facility | None | $54.95 | $302.00 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $660.69 | Professional | None | $48.98 | $58.88 | $660.69 |
United Setting Facility Modifier None Typical Low $125.89 Median $407.38 Typical High $1,778.28 | Facility | None | $125.89 | $407.38 | $1,778.28 |
United Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $89.13 | Professional | None | $48.98 | $53.70 | $89.13 |
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 $22.39 Median $26.92 Typical High $41.69 | Professional | 52 · Reduced service | $22.39 | $26.92 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $10.72 Typical High $16.60 | Professional | 53 · Discontinued | $8.91 | $10.72 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.94 Typical High $12.59 | Professional | 55 · Aftercare only | $6.61 | $7.94 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.37 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.47 | $5.37 | $8.32 |
Where Kansas sits
The same service costs 4.7 times more in Wisconsin than in Kentucky. 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· 27th of 51
$74.13
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.