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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $102.33 | Professional | None | $64.57 | $93.33 | $102.33 |
BCBS Kansas Setting Facility Modifier None Typical Low $302.00 Median $316.23 Typical High $323.59 | Facility | None | $302.00 | $316.23 | $323.59 |
BCBS Kansas Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $97.72 Typical High $602.56 | Facility | None | $64.57 | $97.72 | $602.56 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $67.61 Typical High $794.33 | Professional | None | $44.67 | $67.61 | $794.33 |
United Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $158.49 | Facility | None | $77.62 | $87.10 | $158.49 |
United Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $79.43 | Professional | None | $38.90 | $58.88 | $79.43 |
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 $32.36 Median $46.77 Typical High $51.29 | Professional | 52 · Reduced service | $32.36 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $18.62 Typical High $20.42 | Professional | 53 · Discontinued | $12.88 | $18.62 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $14.13 Typical High $15.14 | Professional | 55 · Aftercare only | $9.77 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.33 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.46 | $9.33 | $10.23 |
Where Kansas sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 1st 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.