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 $302.00 Median $426.58 Typical High $467.74 | Facility | None | $302.00 | $426.58 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $467.74 | Professional | None | $245.47 | $302.00 | $467.74 |
BCBS Kansas Setting Facility Modifier None Typical Low $457.09 Median $489.78 Typical High $489.78 | Facility | None | $457.09 | $489.78 | $489.78 |
BCBS Kansas Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $724.44 Typical High $954.99 | Facility | None | $275.42 | $724.44 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $426.58 Typical High $426.58 | Facility | None | $234.42 | $426.58 | $426.58 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $426.58 | Professional | None | $251.19 | $281.84 | $426.58 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $426.58 | Professional | None | $257.04 | $288.40 | $426.58 |
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 $120.23 Median $147.91 Typical High $234.42 | Professional | 52 · Reduced service | $120.23 | $147.91 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $60.26 Typical High $93.33 | Professional | 53 · Discontinued | $48.98 | $60.26 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $44.67 Typical High $70.79 | Professional | 55 · Aftercare only | $36.31 | $44.67 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $30.20 Typical High $46.77 | Professional | 56 · Pre-op care only | $24.55 | $30.20 | $46.77 |
Where Kansas sits
The same service costs 8.7 times more in Alabama 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
$427
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.