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 $63.10 Median $104.71 Typical High $173.78 | Facility | None | $63.10 | $104.71 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $173.78 | Professional | None | $52.48 | $81.28 | $173.78 |
BCBS Kansas Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $169.82 | Professional | None | $66.07 | $66.07 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $524.81 Typical High $691.83 | Facility | None | $269.15 | $524.81 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $128.82 Typical High $229.09 | Professional | None | $48.98 | $128.82 | $229.09 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $144.54 Typical High $213.80 | Facility | None | $58.88 | $144.54 | $213.80 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $478.63 Typical High $851.14 | Professional | None | $134.90 | $478.63 | $851.14 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $398.11 | Facility | None | $251.19 | $251.19 | $398.11 |
United Setting Professional Modifier None Typical Low $47.86 Median $120.23 Typical High $177.83 | Professional | None | $47.86 | $120.23 | $177.83 |
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 $25.70 Median $40.74 Typical High $87.10 | Professional | 52 · Reduced service | $25.70 | $40.74 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $16.60 Typical High $34.67 | Professional | 53 · Discontinued | $10.47 | $16.60 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $12.30 Typical High $25.70 | Professional | 55 · Aftercare only | $7.76 | $12.30 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $8.13 Typical High $17.38 | Professional | 56 · Pre-op care only | $5.25 | $8.13 | $17.38 |
Where Kansas sits
The same service costs 3.5 times more in Wisconsin than in Washington, DC. 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· 8th of 51
$145
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.