How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $251.19 Median $251.19 Typical High $263.03 | Facility | None | $251.19 | $251.19 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $263.03 | Professional | None | $120.23 | $151.36 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
BCBS Kansas Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $239.88 | Professional | None | $128.82 | $218.78 | $239.88 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $154.88 Typical High $275.42 | Facility | None | $131.83 | $154.88 | $275.42 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $309.03 Typical High $1,174.90 | Professional | None | $134.90 | $309.03 | $1,174.90 |
United Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $208.93 | Professional | None | $123.03 | $158.49 | $208.93 |
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 $60.26 Median $75.86 Typical High $131.83 | Professional | 52 · Reduced service | $60.26 | $75.86 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $30.20 Typical High $52.48 | Professional | 53 · Discontinued | $23.99 | $30.20 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.91 Typical High $38.90 | Professional | 55 · Aftercare only | $18.20 | $22.91 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.14 Typical High $26.30 | Professional | 56 · Pre-op care only | $12.02 | $15.14 | $26.30 |
Where Kansas sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 12th of 51
$178
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.