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 $21.88 Median $26.30 Typical High $33.11 | Facility | None | $21.88 | $26.30 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $26.30 Typical High $26.30 | Professional | None | $19.50 | $26.30 | $26.30 |
BCBS Kansas Setting Facility Modifier None Typical Low $21.38 Median $22.39 Typical High $22.39 | Facility | None | $21.38 | $22.39 | $22.39 |
BCBS Kansas Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $56.23 Typical High $75.86 | Facility | None | $19.50 | $56.23 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Medica Setting Facility Modifier None Typical Low $18.20 Median $23.99 Typical High $25.70 | Facility | None | $18.20 | $23.99 | $25.70 |
Medica Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $23.99 | Professional | None | $18.20 | $18.20 | $23.99 |
United Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | None | $18.62 | $18.62 | $25.70 |
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 $9.55 Median $13.18 Typical High $13.18 | Professional | 52 · Reduced service | $9.55 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $3.89 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.89 Typical High $3.98 | Professional | 55 · Aftercare only | $2.88 | $3.89 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.63 Typical High $2.63 | Professional | 56 · Pre-op care only | $1.95 | $2.63 | $2.63 |
Where Kansas sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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· 13th of 51
$21.38
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.