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 $107.15 Median $120.23 Typical High $162.18 | Facility | None | $107.15 | $120.23 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $151.36 | Professional | None | $87.10 | $109.65 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
BCBS Kansas Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $138.04 | Professional | None | $93.33 | $109.65 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $194.98 | Professional | None | $97.72 | $125.89 | $194.98 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $151.36 Typical High $194.98 | Facility | None | $128.82 | $151.36 | $194.98 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $588.84 Typical High $741.31 | Professional | None | $125.89 | $588.84 | $741.31 |
United Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $158.49 | Professional | None | $100.00 | $120.23 | $158.49 |
3 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 $51.29 Median $63.10 Typical High $81.28 | Professional | 52 · Reduced service | $51.29 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.05 Typical High $23.99 | Professional | 55 · Aftercare only | $15.49 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.59 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.23 | $12.59 | $16.22 |
Where Kansas sits
The same service costs 2.5 times more in Alaska 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· 13th of 51
$126
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.