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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $89.13 | Professional | None | $57.54 | $81.28 | $89.13 |
BCBS Kansas Setting Facility Modifier None Typical Low $70.79 Median $74.13 Typical High $74.13 | Facility | None | $70.79 | $74.13 | $74.13 |
BCBS Kansas Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $87.10 Typical High $501.19 | Facility | None | $56.23 | $87.10 | $501.19 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $58.88 Typical High $562.34 | Professional | None | $38.02 | $58.88 | $562.34 |
United Setting Facility Modifier None Typical Low $29.51 Median $48.98 Typical High $134.90 | Facility | None | $29.51 | $48.98 | $134.90 |
United Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $69.18 | Professional | None | $34.67 | $51.29 | $69.18 |
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 $28.84 Median $40.74 Typical High $44.67 | Professional | 52 · Reduced service | $28.84 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $16.60 Typical High $17.78 | Professional | 53 · Discontinued | $11.48 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.30 Typical High $13.49 | Professional | 55 · Aftercare only | $8.51 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.13 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.75 | $8.13 | $8.91 |
Where Kansas sits
The same service costs 2.4 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· 17th of 51
$74.13
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.