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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $42.66 Typical High $45.71 | Professional | None | $29.51 | $42.66 | $45.71 |
BCBS Kansas Setting Facility Modifier None Typical Low $39.81 Median $41.69 Typical High $41.69 | Facility | None | $39.81 | $41.69 | $41.69 |
BCBS Kansas Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | None | $28.84 | $28.84 | $38.90 |
Medica Setting Facility Modifier None Typical Low $28.84 Median $44.67 Typical High $295.12 | Facility | None | $28.84 | $44.67 | $295.12 |
Medica Setting Professional Modifier None Typical Low $20.42 Median $30.90 Typical High $537.03 | Professional | None | $20.42 | $30.90 | $537.03 |
United Setting Facility Modifier None Typical Low $35.48 Median $51.29 Typical High $72.44 | Facility | None | $35.48 | $51.29 | $72.44 |
United Setting Professional Modifier None Typical Low $17.78 Median $26.92 Typical High $35.48 | Professional | None | $17.78 | $26.92 | $35.48 |
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 $14.79 Median $21.38 Typical High $22.91 | Professional | 52 · Reduced service | $14.79 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $8.51 Typical High $9.12 | Professional | 53 · Discontinued | $5.89 | $8.51 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $6.31 Typical High $6.92 | Professional | 55 · Aftercare only | $4.47 | $6.31 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $4.27 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.95 | $4.27 | $4.57 |
Where Kansas sits
The same service costs 4.7 times more in Hawaii than in Florida. 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· 18th of 51
$41.69
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.