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 $67.61 Median $97.72 Typical High $109.65 | Facility | None | $67.61 | $97.72 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $70.79 Typical High $109.65 | Professional | None | $46.77 | $70.79 | $109.65 |
BCBS Kansas Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
BCBS Kansas Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $100.00 | Professional | None | $74.13 | $74.13 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $52.48 Typical High $56.23 | Facility | None | $44.67 | $52.48 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $144.54 | Professional | None | $48.98 | $75.86 | $144.54 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $186.21 Typical High $1,288.25 | Facility | None | $54.95 | $186.21 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $151.36 Typical High $575.44 | Professional | None | $77.62 | $151.36 | $575.44 |
United Setting Facility Modifier None Typical Low $125.89 Median $398.11 Typical High $1,778.28 | Facility | None | $125.89 | $398.11 | $1,778.28 |
United Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $114.82 | Professional | None | $53.70 | $77.62 | $114.82 |
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 $23.44 Median $33.88 Typical High $54.95 | Professional | 52 · Reduced service | $23.44 | $33.88 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $13.49 Typical High $21.88 | Professional | 53 · Discontinued | $9.33 | $13.49 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.23 Typical High $16.60 | Professional | 55 · Aftercare only | $7.08 | $10.23 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.76 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.68 | $6.76 | $10.96 |
Where Kansas sits
The same service costs 3.1 times more in Wisconsin than in Florida. 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· 20th of 51
$85.11
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.