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 $35.48 Median $35.48 Typical High $60.26 | Facility | None | $35.48 | $35.48 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $35.48 Typical High $37.15 | Professional | None | $28.84 | $35.48 | $37.15 |
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 $32.36 Median $36.31 Typical High $57.54 | Facility | None | $32.36 | $36.31 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $33.88 Typical High $35.48 | Facility | None | $30.20 | $33.88 | $35.48 |
Medica Setting Professional Modifier None Typical Low $33.88 Median $34.67 Typical High $38.02 | Professional | None | $33.88 | $34.67 | $38.02 |
United Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.90 | Facility | None | $30.20 | $30.20 | $30.90 |
United Setting Professional Modifier None Typical Low $33.88 Median $34.67 Typical High $38.02 | Professional | None | $33.88 | $34.67 | $38.02 |
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 $14.45 Median $17.78 Typical High $18.62 | Professional | 52 · Reduced service | $14.45 | $17.78 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.08 Typical High $7.59 | Professional | 53 · Discontinued | $5.75 | $7.08 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.37 Typical High $5.62 | Professional | 55 · Aftercare only | $4.37 | $5.37 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.55 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.88 | $3.55 | $3.72 |
Where Kansas sits
The same service costs 1.6 times more in Arizona than in Georgia. 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· 5th of 51
$38.02
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.