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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $151.36 | Professional | None | $97.72 | $138.04 | $151.36 |
BCBS Kansas Setting Facility Modifier None Typical Low $74.13 Median $77.62 Typical High $77.62 | Facility | None | $74.13 | $77.62 | $77.62 |
BCBS Kansas Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $144.54 Typical High $870.96 | Facility | None | $95.50 | $144.54 | $870.96 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $1,000.00 | Professional | None | $64.57 | $100.00 | $1,000.00 |
United Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $229.09 | Facility | None | $72.44 | $85.11 | $229.09 |
United Setting Professional Modifier None Typical Low $58.88 Median $87.10 Typical High $117.49 | Professional | None | $58.88 | $87.10 | $117.49 |
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 $47.86 Median $69.18 Typical High $75.86 | Professional | 52 · Reduced service | $47.86 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $27.54 Typical High $30.20 | Professional | 53 · Discontinued | $19.50 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $20.89 Typical High $22.91 | Professional | 55 · Aftercare only | $14.45 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $13.80 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.77 | $13.80 | $15.14 |
Where Kansas sits
The same service costs 2.4 times more in Montana than in Vermont. 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· 47th of 51
$91.20
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.