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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $186.21 | Professional | None | $117.49 | $169.82 | $186.21 |
BCBS Kansas Setting Facility Modifier None Typical Low $436.52 Median $457.09 Typical High $457.09 | Facility | None | $436.52 | $457.09 | $457.09 |
BCBS Kansas Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $177.83 Typical High $1,071.52 | Facility | None | $117.49 | $177.83 | $1,071.52 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $123.03 Typical High $1,258.93 | Professional | None | $77.62 | $123.03 | $1,258.93 |
United Setting Facility Modifier None Typical Low $63.10 Median $128.82 Typical High $275.42 | Facility | None | $63.10 | $128.82 | $275.42 |
United Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $144.54 | Professional | None | $70.79 | $107.15 | $144.54 |
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 $58.88 Median $85.11 Typical High $93.33 | Professional | 52 · Reduced service | $58.88 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.88 Typical High $37.15 | Professional | 53 · Discontinued | $23.44 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $25.70 Typical High $27.54 | Professional | 55 · Aftercare only | $17.78 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.98 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.75 | $16.98 | $18.62 |
Where Kansas sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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
$389
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.