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 $602.56 Median $602.56 Typical High $630.96 | Facility | None | $602.56 | $602.56 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $630.96 | Professional | None | $288.40 | $371.54 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $346.74 | Professional | None | $275.42 | $302.00 | $346.74 |
BCBS Kansas Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $467.74 | Professional | None | $251.19 | $416.87 | $467.74 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $316.23 Typical High $660.69 | Facility | None | $269.15 | $316.23 | $660.69 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $501.19 Typical High $1,905.46 | Professional | None | $269.15 | $501.19 | $1,905.46 |
United Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $416.87 | Professional | None | $251.19 | $302.00 | $416.87 |
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 $144.54 Median $181.97 Typical High $316.23 | Professional | 52 · Reduced service | $144.54 | $181.97 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $74.13 Typical High $125.89 | Professional | 53 · Discontinued | $57.54 | $74.13 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $54.95 Typical High $95.50 | Professional | 55 · Aftercare only | $43.65 | $54.95 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $37.15 Typical High $63.10 | Professional | 56 · Pre-op care only | $28.84 | $37.15 | $63.10 |
Where Kansas sits
The same service costs 2.8 times more in Alaska than in New York. 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· 18th of 51
$363
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.