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 $245.47 Median $245.47 Typical High $288.40 | Facility | None | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $288.40 | Professional | None | $213.80 | $245.47 | $288.40 |
BCBS Kansas Setting Facility Modifier None Typical Low $245.47 Median $257.04 Typical High $257.04 | Facility | None | $245.47 | $257.04 | $257.04 |
BCBS Kansas Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $616.60 Typical High $831.76 | Facility | None | $218.78 | $616.60 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $234.42 Typical High $281.84 | Facility | None | $208.93 | $234.42 | $281.84 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $239.88 | Professional | None | $213.80 | $213.80 | $239.88 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $239.88 | Professional | None | $213.80 | $213.80 | $239.88 |
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 $107.15 Median $120.23 Typical High $144.54 | Professional | 52 · Reduced service | $107.15 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $48.98 Typical High $57.54 | Professional | 53 · Discontinued | $42.66 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $36.31 Typical High $43.65 | Professional | 55 · Aftercare only | $32.36 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $24.55 Typical High $28.84 | Professional | 56 · Pre-op care only | $21.38 | $24.55 | $28.84 |
Where Kansas sits
The same service costs 7.6 times more in Alabama than in New Mexico. 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· 8th of 51
$245
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.