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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $478.63 | Professional | None | $309.03 | $446.68 | $478.63 |
BCBS Kansas Setting Facility Modifier None Typical Low $426.58 Median $436.52 Typical High $446.68 | Facility | None | $426.58 | $436.52 | $446.68 |
BCBS Kansas Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $467.74 Typical High $2,630.27 | Facility | None | $302.00 | $467.74 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $2,818.38 | Professional | None | $194.98 | $302.00 | $2,818.38 |
United Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $691.83 | Facility | None | $588.84 | $588.84 | $691.83 |
United Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $371.54 | Professional | None | $186.21 | $281.84 | $371.54 |
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 $154.88 Median $223.87 Typical High $239.88 | Professional | 52 · Reduced service | $154.88 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $89.13 Typical High $97.72 | Professional | 53 · Discontinued | $61.66 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $66.07 Typical High $72.44 | Professional | 55 · Aftercare only | $46.77 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $44.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $30.90 | $44.67 | $47.86 |
Where Kansas sits
The same service costs 2.6 times more in Montana 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· 14th of 51
$447
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.