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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $45.71 Typical High $50.12 | Professional | None | $31.62 | $45.71 | $50.12 |
BCBS Kansas Setting Facility Modifier None Typical Low $81.28 Median $85.11 Typical High $85.11 | Facility | None | $81.28 | $85.11 | $85.11 |
BCBS Kansas Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | None | $44.67 | $44.67 | $52.48 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $54.95 Typical High $257.04 | Facility | None | $36.31 | $54.95 | $257.04 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $54.95 Typical High $389.05 | Professional | None | $33.11 | $54.95 | $389.05 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $93.33 | Facility | None | $79.43 | $79.43 | $93.33 |
United Setting Professional Modifier None Typical Low $28.18 Median $46.77 Typical High $63.10 | Professional | None | $28.18 | $46.77 | $63.10 |
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 $22.91 Typical High $25.12 | Professional | 52 · Reduced service | $15.85 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $9.12 Typical High $10.00 | Professional | 53 · Discontinued | $6.31 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.92 Typical High $7.41 | Professional | 55 · Aftercare only | $4.79 | $6.92 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $4.57 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.16 | $4.57 | $5.01 |
Where Kansas sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 3rd of 51
$81.28
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.