How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $239.88 Median $263.03 Typical High $380.19 | Facility | None | $239.88 | $263.03 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $263.03 | Professional | None | $199.53 | $251.19 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $173.78 | Professional | None | $89.13 | $89.13 | $173.78 |
BCBS Kansas Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $812.83 Typical High $1,096.48 | Facility | None | $426.58 | $812.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $616.60 | Facility | None | $204.17 | $309.03 | $616.60 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $338.84 Typical High $1,174.90 | Professional | None | $162.18 | $338.84 | $1,174.90 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $616.60 | Facility | None | $389.05 | $389.05 | $616.60 |
United Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $338.84 | Professional | None | $154.88 | $177.83 | $338.84 |
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 $107.15 Median $125.89 Typical High $131.83 | Professional | 52 · Reduced service | $107.15 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $50.12 Typical High $52.48 | Professional | 53 · Discontinued | $42.66 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $37.15 Typical High $38.90 | Professional | 55 · Aftercare only | $32.36 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $25.12 Typical High $26.30 | Professional | 56 · Pre-op care only | $21.38 | $25.12 | $26.30 |
Where Kansas sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 21st of 51
$219
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.