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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $549.54 | Professional | None | $354.81 | $512.86 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
BCBS Kansas Setting Facility Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,174.90 | $1,230.27 | $1,230.27 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | None | $467.74 | $467.74 | $630.96 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $645.65 Typical High $3,162.28 | Facility | None | $416.87 | $645.65 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $660.69 Typical High $4,466.84 | Professional | None | $389.05 | $660.69 | $4,466.84 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Facility | None | $812.83 | $812.83 | $954.99 |
United Setting Professional Modifier None Typical Low $323.59 Median $537.03 Typical High $724.44 | Professional | None | $323.59 | $537.03 | $724.44 |
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 $177.83 Median $257.04 Typical High $275.42 | Professional | 52 · Reduced service | $177.83 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $102.33 Typical High $112.20 | Professional | 53 · Discontinued | $70.79 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $53.70 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $51.29 Typical High $54.95 | Professional | 56 · Pre-op care only | $35.48 | $51.29 | $54.95 |
Where Kansas sits
The same service costs 2.2 times more in Kansas 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· 1st of 51
$1,000
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.