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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $95.50 | Professional | None | $61.66 | $87.10 | $95.50 |
BCBS Kansas Setting Facility Modifier None Typical Low $89.13 Median $93.33 Typical High $93.33 | Facility | None | $89.13 | $93.33 | $93.33 |
BCBS Kansas Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $60.26 Median $91.20 Typical High $562.34 | Facility | None | $60.26 | $91.20 | $562.34 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $691.83 | Professional | None | $41.69 | $63.10 | $691.83 |
United Setting Facility Modifier None Typical Low $69.18 Median $72.44 Typical High $147.91 | Facility | None | $69.18 | $72.44 | $147.91 |
United Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $74.13 | Professional | None | $37.15 | $54.95 | $74.13 |
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 $30.20 Median $43.65 Typical High $47.86 | Professional | 52 · Reduced service | $30.20 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $17.38 Typical High $19.05 | Professional | 53 · Discontinued | $12.30 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $13.18 Typical High $14.45 | Professional | 55 · Aftercare only | $9.12 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.71 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.17 | $8.71 | $9.55 |
Where Kansas sits
The same service costs 3.1 times more in Hawaii 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· 15th of 51
$93.33
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.