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 $138.04 Median $169.82 Typical High $295.12 | Facility | None | $138.04 | $169.82 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $295.12 | Professional | None | $117.49 | $158.49 | $295.12 |
BCBS Kansas Setting Facility Modifier None Typical Low $234.42 Median $245.47 Typical High $245.47 | Facility | None | $234.42 | $245.47 | $245.47 |
BCBS Kansas Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $338.84 Typical High $457.09 | Facility | None | $120.23 | $338.84 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $251.19 | Facility | None | $181.97 | $181.97 | $251.19 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $316.23 | Professional | None | $194.98 | $194.98 | $316.23 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $269.15 | Professional | None | $147.91 | $147.91 | $269.15 |
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 $58.88 Median $79.43 Typical High $147.91 | Professional | 52 · Reduced service | $58.88 | $79.43 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $31.62 Typical High $58.88 | Professional | 53 · Discontinued | $23.44 | $31.62 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $23.99 Typical High $43.65 | Professional | 55 · Aftercare only | $17.78 | $23.99 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.85 Typical High $29.51 | Professional | 56 · Pre-op care only | $11.75 | $15.85 | $29.51 |
Where Kansas sits
The same service costs 2.0 times more in Kansas 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· 1st of 51
$234
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.