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 $89.13 Median $91.20 Typical High $131.83 | Facility | None | $89.13 | $91.20 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $104.71 | Professional | None | $75.86 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $38.02 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $18.20 Typical High $20.89 | Professional | 53 · Discontinued | $15.14 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $69.18 Typical High $77.62 | Professional | 54 · Surgery only | $57.54 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.80 Typical High $15.49 | Professional | 55 · Aftercare only | $11.48 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.59 | $9.12 | $10.47 |
BCBS Kansas Setting Facility Modifier None Typical Low $85.11 Median $91.20 Typical High $91.20 | Facility | None | $85.11 | $91.20 | $91.20 |
BCBS Kansas Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $331.13 Typical High $371.54 | Facility | None | $95.50 | $331.13 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $97.72 | Facility | None | $70.79 | $83.18 | $97.72 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $87.10 | Professional | None | $74.13 | $74.13 | $87.10 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | None | $75.86 | $75.86 | $89.13 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | JW · Drug discarded | $75.86 | $75.86 | $75.86 |
Where Kansas sits
Rates are fairly even across states for this service. 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· 38th of 51
$75.86
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.