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 $120.23 Median $120.23 Typical High $295.12 | Facility | None | $120.23 | $120.23 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $169.82 | Professional | None | $131.83 | $165.96 | $169.82 |
BCBS Kansas Setting Facility Modifier None Typical Low $204.17 Median $213.80 Typical High $213.80 | Facility | None | $204.17 | $213.80 | $213.80 |
BCBS Kansas Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $398.11 Typical High $537.03 | Facility | None | $154.88 | $398.11 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $186.21 | Professional | None | $181.97 | $181.97 | $186.21 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $169.82 | Facility | None | $112.20 | $112.20 | $169.82 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $194.98 | Professional | None | $138.04 | $154.88 | $194.98 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $199.53 | Professional | None | $151.36 | $165.96 | $199.53 |
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 $66.07 Median $81.28 Typical High $85.11 | Professional | 52 · Reduced service | $66.07 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $33.11 Typical High $33.88 | Professional | 53 · Discontinued | $26.30 | $33.11 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $24.55 Typical High $25.12 | Professional | 55 · Aftercare only | $19.95 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.60 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.18 | $16.60 | $16.98 |
Where Kansas sits
The same service costs 1.8 times more in Arizona than in Rhode Island. 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· 4th 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.