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 $165.96 Median $190.55 Typical High $199.53 | Facility | None | $165.96 | $190.55 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $199.53 | Professional | None | $144.54 | $190.55 | $199.53 |
BCBS Kansas Setting Facility Modifier None Typical Low $158.49 Median $169.82 Typical High $169.82 | Facility | None | $158.49 | $169.82 | $169.82 |
BCBS Kansas Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $426.58 Typical High $562.34 | Facility | None | $147.91 | $426.58 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $165.96 Typical High $177.83 | Facility | None | $134.90 | $165.96 | $177.83 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $144.54 Typical High $186.21 | Professional | None | $141.25 | $144.54 | $186.21 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $194.98 | Professional | None | $141.25 | $141.25 | $194.98 |
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 $72.44 Median $95.50 Typical High $97.72 | Professional | 52 · Reduced service | $72.44 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $38.02 Typical High $39.81 | Professional | 53 · Discontinued | $28.84 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.84 Typical High $29.51 | Professional | 55 · Aftercare only | $21.88 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $19.05 Typical High $19.95 | Professional | 56 · Pre-op care only | $14.45 | $19.05 | $19.95 |
Where Kansas sits
The same service costs 1.5 times more in Arizona than in Oregon. 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· 14th of 51
$158
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.