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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $257.04 | Professional | None | $165.96 | $239.88 | $257.04 |
BCBS Kansas Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $154.88 | Facility | None | $147.91 | $154.88 | $154.88 |
BCBS Kansas Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $251.19 Typical High $1,621.81 | Facility | None | $162.18 | $251.19 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $2,137.96 | Professional | None | $114.82 | $173.78 | $2,137.96 |
United Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $407.38 | Facility | None | $199.53 | $204.17 | $407.38 |
United Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $199.53 | Professional | None | $100.00 | $151.36 | $199.53 |
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 $83.18 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $83.18 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $47.86 Typical High $51.29 | Professional | 53 · Discontinued | $33.11 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $25.12 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $23.99 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.60 | $23.99 | $25.70 |
Where Kansas sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 26th of 51
$195
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.