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 $269.15 Median $269.15 Typical High $478.63 | Facility | None | $269.15 | $269.15 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $295.12 | Professional | None | $229.09 | $281.84 | $295.12 |
BCBS Kansas Setting Facility Modifier None Typical Low $281.84 Median $295.12 Typical High $295.12 | Facility | None | $281.84 | $295.12 | $295.12 |
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 $257.04 Median $288.40 Typical High $457.09 | Facility | None | $257.04 | $288.40 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $213.80 Typical High $257.04 | Facility | None | $208.93 | $213.80 | $257.04 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $251.19 | Professional | None | $223.87 | $245.47 | $251.19 |
United Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $269.15 | Professional | None | $239.88 | $263.03 | $269.15 |
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 $114.82 Median $141.25 Typical High $147.91 | Professional | 52 · Reduced service | $114.82 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $56.23 Typical High $60.26 | Professional | 53 · Discontinued | $45.71 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $42.66 Typical High $44.67 | Professional | 55 · Aftercare only | $34.67 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.18 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.91 | $28.18 | $29.51 |
Where Kansas sits
The same service costs 2.0 times more in Arizona 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· 3rd of 51
$282
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.