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 $109.65 Median $162.18 Typical High $199.53 | Facility | None | $109.65 | $162.18 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $128.82 | Professional | None | $95.50 | $109.65 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
BCBS Kansas Setting Facility Modifier None Typical Low $1,995.26 Median $3,801.89 Typical High $3,981.07 | Facility | None | $1,995.26 | $3,801.89 | $3,981.07 |
BCBS Kansas Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $2,089.30 Typical High $2,398.83 | Facility | None | $389.05 | $2,089.30 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $223.87 | Professional | None | $102.33 | $151.36 | $223.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,148.15 Typical High $5,128.61 | Facility | None | $54.95 | $1,148.15 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $1,513.56 | Professional | None | $100.00 | $131.83 | $1,513.56 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,737.80 Typical High $4,677.35 | Facility | None | $831.76 | $1,737.80 | $4,677.35 |
United Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $173.78 | Professional | None | $100.00 | $112.20 | $173.78 |
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 $46.77 Median $54.95 Typical High $56.23 | Professional | 52 · Reduced service | $46.77 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $21.88 Typical High $22.39 | Professional | 53 · Discontinued | $19.05 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $16.22 Typical High $16.98 | Professional | 55 · Aftercare only | $14.13 | $16.22 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.96 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.33 | $10.96 | $11.22 |
Where Kansas sits
The same service costs 7.9 times more in Kansas 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· 1st of 51
$832
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.