How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $81.28 Median $81.28 Typical High $89.13 | Facility | None | $81.28 | $81.28 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $91.20 | Professional | None | $72.44 | $81.28 | $91.20 |
BCBS Kansas Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $89.13 Typical High $190.55 | Facility | None | $77.62 | $89.13 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $89.13 Typical High $186.21 | Professional | None | $45.71 | $89.13 | $186.21 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $97.72 Typical High $316.23 | Facility | None | $81.28 | $97.72 | $316.23 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $562.34 Typical High $588.84 | Professional | None | $100.00 | $562.34 | $588.84 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $316.23 | Facility | None | $199.53 | $199.53 | $316.23 |
United Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $141.25 | Professional | None | $61.66 | $100.00 | $141.25 |
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 $36.31 Median $40.74 Typical High $45.71 | Professional | 52 · Reduced service | $36.31 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.22 Typical High $18.20 | Professional | 53 · Discontinued | $14.45 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.30 Typical High $13.80 | Professional | 55 · Aftercare only | $10.96 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.13 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.24 | $8.13 | $9.12 |
Where Kansas sits
The same service costs 5.0 times more in Alaska than in Alabama. 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· 12th of 51
$123
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.