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 $1,949.84 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,949.84 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $218.78 | Professional | None | $162.18 | $169.82 | $218.78 |
BCBS Kansas Setting Facility Modifier None Typical Low $537.03 Median $575.44 Typical High $575.44 | Facility | None | $537.03 | $575.44 | $575.44 |
BCBS Kansas Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $309.03 Typical High $5,011.87 | Facility | None | $151.36 | $309.03 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
5 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 $81.28 Median $85.11 Typical High $109.65 | Professional | 52 · Reduced service | $81.28 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.88 Typical High $43.65 | Professional | 53 · Discontinued | $32.36 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $128.82 Typical High $165.96 | Professional | 54 · Surgery only | $123.03 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.70 Typical High $33.11 | Professional | 55 · Aftercare only | $24.55 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.98 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.22 | $16.98 | $21.88 |
Where Kansas sits
The same service costs 7.6 times more in Nebraska than in West Virginia. 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· 5th of 51
$537
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.