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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $85.11 Typical High $87.10 | Professional | None | $36.31 | $85.11 | $87.10 |
BCBS Kansas Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $79.43 | Facility | None | $75.86 | $75.86 | $79.43 |
BCBS Kansas Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $41.69 | Facility | None | $39.81 | $39.81 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
Medica Setting Facility Modifier None Typical Low $34.67 Median $56.23 Typical High $309.03 | Facility | None | $34.67 | $56.23 | $309.03 |
Medica Setting Professional Modifier None Typical Low $21.88 Median $38.02 Typical High $323.59 | Professional | None | $21.88 | $38.02 | $323.59 |
United Setting Professional Modifier None Typical Low $19.50 Median $33.11 Typical High $41.69 | Professional | None | $19.50 | $33.11 | $41.69 |
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 $19.95 Median $42.66 Typical High $43.65 | Professional | 52 · Reduced service | $19.95 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $16.98 Typical High $17.38 | Professional | 53 · Discontinued | $7.94 | $16.98 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $6.03 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $8.51 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.98 | $8.51 | $8.71 |
Where Kansas sits
The same service costs 2.3 times more in Kansas than in New Jersey. 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· 1st of 51
$79.43
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.