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 $21.38 Median $24.55 Typical High $44.67 | Facility | None | $21.38 | $24.55 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $24.55 Typical High $25.70 | Professional | None | $19.95 | $24.55 | $25.70 |
BCBS Kansas Setting Facility Modifier None Typical Low $26.30 Median $28.18 Typical High $28.18 | Facility | None | $26.30 | $28.18 | $28.18 |
BCBS Kansas Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $25.70 Typical High $39.81 | Facility | None | $22.39 | $25.70 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Medica Setting Facility Modifier None Typical Low $20.89 Median $23.44 Typical High $24.55 | Facility | None | $20.89 | $23.44 | $24.55 |
Medica Setting Professional Modifier None Typical Low $23.44 Median $23.99 Typical High $26.30 | Professional | None | $23.44 | $23.99 | $26.30 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
United Setting Professional Modifier None Typical Low $23.44 Median $23.99 Typical High $26.30 | Professional | None | $23.44 | $23.99 | $26.30 |
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 $10.00 Median $12.30 Typical High $12.88 | Professional | 52 · Reduced service | $10.00 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $4.90 Typical High $5.13 | Professional | 53 · Discontinued | $3.98 | $4.90 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.72 Typical High $3.89 | Professional | 55 · Aftercare only | $3.02 | $3.72 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.45 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.00 | $2.45 | $2.57 |
Where Kansas sits
The same service costs 1.9 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· 6th of 51
$26.30
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.