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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $81.28 | Professional | None | $52.48 | $74.13 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
BCBS Kansas Setting Facility Modifier None Typical Low $79.43 Median $85.11 Typical High $85.11 | Facility | None | $79.43 | $85.11 | $85.11 |
BCBS Kansas Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None | $42.66 | $42.66 | $57.54 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $79.43 Typical High $467.74 | Facility | None | $51.29 | $79.43 | $467.74 |
Medica Setting Professional Modifier None Typical Low $34.67 Median $54.95 Typical High $588.84 | Professional | None | $34.67 | $54.95 | $588.84 |
United Setting Facility Modifier None Typical Low $43.65 Median $51.29 Typical High $123.03 | Facility | None | $43.65 | $51.29 | $123.03 |
United Setting Professional Modifier None Typical Low $31.62 Median $47.86 Typical High $63.10 | Professional | None | $31.62 | $47.86 | $63.10 |
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 $26.30 Median $37.15 Typical High $40.74 | Professional | 52 · Reduced service | $26.30 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $15.14 Typical High $16.22 | Professional | 53 · Discontinued | $10.47 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $11.22 Typical High $12.30 | Professional | 55 · Aftercare only | $7.76 | $11.22 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.59 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.25 | $7.59 | $8.13 |
Where Kansas sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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
$81.28
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.