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 $147.91 Median $147.91 Typical High $177.83 | Facility | None | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $177.83 | Professional | None | $128.82 | $147.91 | $177.83 |
BCBS Kansas Setting Facility Modifier None Typical Low $151.36 Median $158.49 Typical High $158.49 | Facility | None | $151.36 | $158.49 | $158.49 |
BCBS Kansas Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $380.19 Typical High $512.86 | Facility | None | $131.83 | $380.19 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $147.91 Typical High $173.78 | Facility | None | $128.82 | $147.91 | $173.78 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | None | $128.82 | $128.82 | $144.54 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | None | $128.82 | $128.82 | $147.91 |
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 $64.57 Median $74.13 Typical High $89.13 | Professional | 52 · Reduced service | $64.57 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $29.51 Typical High $35.48 | Professional | 53 · Discontinued | $25.70 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.88 Typical High $26.30 | Professional | 55 · Aftercare only | $19.50 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.79 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.88 | $14.79 | $17.78 |
Where Kansas sits
The same service costs 1.6 times more in Texas than in North Carolina. 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· 9th of 51
$151
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.