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 $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $251.19 | Professional | None | $162.18 | $234.42 | $251.19 |
BCBS Kansas Setting Facility Modifier None Typical Low $223.87 Median $234.42 Typical High $239.88 | Facility | None | $223.87 | $234.42 | $239.88 |
BCBS Kansas Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $245.47 Typical High $1,548.82 | Facility | None | $158.49 | $245.47 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $1,949.84 | Professional | None | $112.20 | $169.82 | $1,949.84 |
United Setting Facility Modifier None Typical Low $190.55 Median $194.98 Typical High $398.11 | Facility | None | $190.55 | $194.98 | $398.11 |
United Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $194.98 | Professional | None | $97.72 | $147.91 | $194.98 |
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 $81.28 Median $117.49 Typical High $125.89 | Professional | 52 · Reduced service | $81.28 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $32.36 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $34.67 Typical High $38.02 | Professional | 55 · Aftercare only | $24.55 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.44 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.22 | $23.44 | $25.12 |
Where Kansas sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 14th of 51
$240
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.