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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $16.22 Typical High $16.60 | Professional | None | $7.59 | $16.22 | $16.60 |
BCBS Kansas Setting Facility Modifier None Typical Low $8.71 Median $9.12 Typical High $9.12 | Facility | None | $8.71 | $9.12 | $9.12 |
BCBS Kansas Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $10.47 | Professional | None | $9.12 | $9.12 | $10.47 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.59 | Professional | None | $6.31 | $6.31 | $7.59 |
Medica Setting Facility Modifier None Typical Low $6.61 Median $10.72 Typical High $79.43 | Facility | None | $6.61 | $10.72 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.17 Median $7.08 Typical High $107.15 | Professional | None | $4.17 | $7.08 | $107.15 |
United Setting Professional Modifier None Typical Low $3.72 Median $6.31 Typical High $7.94 | Professional | None | $3.72 | $6.31 | $7.94 |
2 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 55 · Aftercare only Typical Low $1.12 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $1.12 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $1.62 Typical High $1.66 | Professional | 56 · Pre-op care only | $0.76 | $1.62 | $1.66 |
Where Kansas sits
The same service costs 5.0 times more in Hawaii than in Rhode Island. 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· 16th of 51
$9.12
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.