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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $117.49 | Professional | None | $74.13 | $107.15 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
BCBS Kansas Setting Facility Modifier None Typical Low $177.83 Median $181.97 Typical High $186.21 | Facility | None | $177.83 | $181.97 | $186.21 |
BCBS Kansas Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $112.20 Typical High $724.44 | Facility | None | $74.13 | $112.20 | $724.44 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $1,288.25 | Professional | None | $52.48 | $77.62 | $1,288.25 |
United Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $186.21 | Facility | None | $91.20 | $120.23 | $186.21 |
United Setting Professional Modifier None Typical Low $44.67 Median $67.61 Typical High $91.20 | Professional | None | $44.67 | $67.61 | $91.20 |
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 $37.15 Median $53.70 Typical High $58.88 | Professional | 52 · Reduced service | $37.15 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $21.38 Typical High $23.44 | Professional | 53 · Discontinued | $14.79 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $16.22 Typical High $17.38 | Professional | 55 · Aftercare only | $11.22 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.72 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.41 | $10.72 | $11.75 |
Where Kansas sits
The same service costs 5.0 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· 6th of 51
$148
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.