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 $87.10 Median $87.10 Typical High $158.49 | Facility | None | $87.10 | $87.10 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $95.50 | Professional | None | $75.86 | $93.33 | $95.50 |
BCBS Kansas Setting Facility Modifier None Typical Low $93.33 Median $97.72 Typical High $97.72 | Facility | None | $93.33 | $97.72 | $97.72 |
BCBS Kansas Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $93.33 Typical High $147.91 | Facility | None | $83.18 | $93.33 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $102.33 | Professional | None | $81.28 | $81.28 | $102.33 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $79.43 Typical High $91.20 | Facility | None | $74.13 | $79.43 | $91.20 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $83.18 | Professional | None | $74.13 | $81.28 | $83.18 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $77.62 | Facility | None | $75.86 | $75.86 | $77.62 |
United Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $87.10 | Professional | None | $77.62 | $85.11 | $87.10 |
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 $37.15 Median $45.71 Typical High $47.86 | Professional | 52 · Reduced service | $37.15 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $18.62 Typical High $19.05 | Professional | 53 · Discontinued | $15.14 | $18.62 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.80 Typical High $14.13 | Professional | 55 · Aftercare only | $11.22 | $13.80 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.33 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.59 | $9.33 | $9.55 |
Where Kansas sits
The same service costs 3.0 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· 2nd of 51
$93.33
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.