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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $190.55 | Professional | None | $120.23 | $173.78 | $190.55 |
BCBS Kansas Setting Facility Modifier None Typical Low $239.88 Median $251.19 Typical High $251.19 | Facility | None | $239.88 | $251.19 | $251.19 |
BCBS Kansas Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $269.15 Typical High $1,096.48 | Facility | None | $138.04 | $269.15 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $1,659.59 | Professional | None | $125.89 | $190.55 | $1,659.59 |
United Setting Facility Modifier None Typical Low $213.80 Median $234.42 Typical High $407.38 | Facility | None | $213.80 | $234.42 | $407.38 |
United Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $223.87 | Professional | None | $107.15 | $165.96 | $223.87 |
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 $60.26 Median $87.10 Typical High $95.50 | Professional | 52 · Reduced service | $60.26 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $34.67 Typical High $38.02 | Professional | 53 · Discontinued | $24.55 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $26.30 Typical High $28.18 | Professional | 55 · Aftercare only | $18.20 | $26.30 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $17.38 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.02 | $17.38 | $19.05 |
Where Kansas sits
The same service costs 2.9 times more in Hawaii than in Utah. 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· 8th 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.