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 $39.81 Median $39.81 Typical High $48.98 | Facility | None | $39.81 | $39.81 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $48.98 | Professional | None | $39.81 | $41.69 | $48.98 |
BCBS Kansas Setting Facility Modifier None Typical Low $75.86 Median $79.43 Typical High $79.43 | Facility | None | $75.86 | $79.43 | $79.43 |
BCBS Kansas Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $29.51 Typical High $46.77 | Facility | None | $26.30 | $29.51 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $33.11 | Professional | None | $21.88 | $25.70 | $33.11 |
Medica Setting Facility Modifier None Typical Low $29.51 Median $33.88 Typical High $58.88 | Facility | None | $29.51 | $33.88 | $58.88 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $70.79 Typical High $70.79 | Professional | None | $28.84 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $28.84 Median $70.79 Typical High $70.79 | Professional | None | $28.84 | $70.79 | $70.79 |
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 $19.50 Median $20.89 Typical High $24.55 | Professional | 52 · Reduced service | $19.50 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.32 Typical High $9.77 | Professional | 53 · Discontinued | $7.94 | $8.32 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.31 Typical High $7.41 | Professional | 55 · Aftercare only | $5.89 | $6.31 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.17 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.98 | $4.17 | $4.90 |
Where Kansas sits
The same service costs 3.1 times more in Wisconsin than in New York. 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· 6th of 51
$66.07
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.