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 $79.43 Median $125.89 Typical High $208.93 | Facility | None | $79.43 | $125.89 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $120.23 | Professional | None | $75.86 | $114.82 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
BCBS Kansas Setting Facility Modifier None Typical Low $46.77 Median $48.98 Typical High $74.13 | Facility | None | $46.77 | $48.98 | $74.13 |
BCBS Kansas Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $117.49 Typical High $478.63 | Facility | None | $72.44 | $117.49 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $147.91 | Professional | None | $60.26 | $60.26 | $147.91 |
Medica Setting Facility Modifier None Typical Low $43.65 Median $100.00 Typical High $346.74 | Facility | None | $43.65 | $100.00 | $346.74 |
Medica Setting Professional Modifier None Typical Low $47.86 Median $69.18 Typical High $100.00 | Professional | None | $47.86 | $69.18 | $100.00 |
United Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $114.82 | Facility | None | $69.18 | $69.18 | $114.82 |
United Setting Professional Modifier None Typical Low $47.86 Median $69.18 Typical High $134.90 | Professional | None | $47.86 | $69.18 | $134.90 |
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 $48.98 Median $57.54 Typical High $60.26 | Professional | 52 · Reduced service | $48.98 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $22.91 Typical High $23.99 | Professional | 53 · Discontinued | $19.50 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $85.11 Typical High $91.20 | Professional | 54 · Surgery only | $74.13 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.98 Typical High $18.20 | Professional | 55 · Aftercare only | $14.79 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.48 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.77 | $11.48 | $12.02 |
Where Kansas sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 48th of 51
$69.18
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.