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 $36.31 Median $36.31 Typical High $67.61 | Facility | None | $36.31 | $36.31 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $39.81 Typical High $39.81 | Professional | None | $32.36 | $39.81 | $39.81 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
BCBS Kansas Setting Facility Modifier None Typical Low $38.90 Median $40.74 Typical High $40.74 | Facility | None | $38.90 | $40.74 | $40.74 |
BCBS Kansas Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $39.81 Typical High $61.66 | Facility | None | $34.67 | $39.81 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Medica Setting Facility Modifier None Typical Low $29.51 Median $33.11 Typical High $38.02 | Facility | None | $29.51 | $33.11 | $38.02 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $35.48 Typical High $36.31 | Professional | None | $32.36 | $35.48 | $36.31 |
United Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $37.15 | Professional | None | $33.11 | $36.31 | $37.15 |
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 $16.22 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $16.22 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $6.46 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $4.90 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.24 | $3.98 | $3.98 |
Where Kansas sits
The same service costs 5.4 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· 2nd of 51
$38.90
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.