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 $37.15 Median $67.61 Typical High $67.61 | Facility | None | $37.15 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $43.65 Typical High $67.61 | Professional | None | $31.62 | $43.65 | $67.61 |
BCBS Kansas Setting Facility Modifier None Typical Low $38.90 Median $41.69 Typical High $41.69 | Facility | None | $38.90 | $41.69 | $41.69 |
BCBS Kansas Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $109.65 Typical High $123.03 | Facility | None | $32.36 | $109.65 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Medica Setting Facility Modifier None Typical Low $32.36 Median $67.61 Typical High $67.61 | Facility | None | $32.36 | $67.61 | $67.61 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $53.70 | Professional | None | $31.62 | $31.62 | $53.70 |
United Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $53.70 | Professional | None | $31.62 | $31.62 | $53.70 |
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 $15.85 Median $21.38 Typical High $33.11 | Professional | 52 · Reduced service | $15.85 | $21.38 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $8.71 Typical High $13.49 | Professional | 53 · Discontinued | $6.31 | $8.71 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.46 Typical High $10.00 | Professional | 55 · Aftercare only | $4.79 | $6.46 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $4.37 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.16 | $4.37 | $6.76 |
Where Kansas sits
The same service costs 3.8 times more in Alabama than in Virginia. 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
$38.90
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.