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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $69.18 Typical High $75.86 | Professional | None | $47.86 | $69.18 | $75.86 |
BCBS Kansas Setting Facility Modifier None Typical Low $74.13 Median $77.62 Typical High $77.62 | Facility | None | $74.13 | $77.62 | $77.62 |
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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $72.44 Typical High $467.74 | Facility | None | $47.86 | $72.44 | $467.74 |
Medica Setting Professional Modifier None Typical Low $33.88 Median $50.12 Typical High $676.08 | Professional | None | $33.88 | $50.12 | $676.08 |
United Setting Facility Modifier None Typical Low $57.54 Median $60.26 Typical High $117.49 | Facility | None | $57.54 | $60.26 | $117.49 |
United Setting Professional Modifier None Typical Low $28.84 Median $43.65 Typical High $58.88 | Professional | None | $28.84 | $43.65 | $58.88 |
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 $23.99 Median $34.67 Typical High $37.15 | Professional | 52 · Reduced service | $23.99 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $13.80 Typical High $15.14 | Professional | 53 · Discontinued | $9.55 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.23 Typical High $11.22 | Professional | 55 · Aftercare only | $7.24 | $10.23 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.92 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.79 | $6.92 | $7.59 |
Where Kansas sits
The same service costs 3.5 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
$75.86
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.