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 $120.23 Median $151.36 Typical High $151.36 | Facility | None | $120.23 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | None | $120.23 | $151.36 | $151.36 |
BCBS Kansas Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $151.36 | Facility | None | $144.54 | $151.36 | $151.36 |
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 $128.82 Median $147.91 Typical High $229.09 | Facility | None | $128.82 | $147.91 | $229.09 |
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 $131.83 Median $151.36 Typical High $177.83 | Facility | None | $131.83 | $151.36 | $177.83 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | None | $125.89 | $125.89 | $151.36 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | None | $125.89 | $125.89 | $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 $60.26 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $60.26 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $23.99 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $18.20 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.02 | $15.14 | $15.14 |
Where Kansas sits
The same service costs 2.3 times more in Texas than in Hawaii. 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
$145
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.