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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $81.28 | Professional | None | $52.48 | $74.13 | $81.28 |
BCBS Kansas Setting Facility Modifier None Typical Low $75.86 Median $79.43 Typical High $79.43 | Facility | None | $75.86 | $79.43 | $79.43 |
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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $77.62 Typical High $489.78 | Facility | None | $51.29 | $77.62 | $489.78 |
Medica Setting Professional Modifier None Typical Low $35.48 Median $53.70 Typical High $794.33 | Professional | None | $35.48 | $53.70 | $794.33 |
United Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $125.89 | Facility | None | $61.66 | $63.10 | $125.89 |
United Setting Professional Modifier None Typical Low $31.62 Median $46.77 Typical High $63.10 | Professional | None | $31.62 | $46.77 | $63.10 |
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 $26.30 Median $37.15 Typical High $40.74 | Professional | 52 · Reduced service | $26.30 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $14.79 Typical High $16.22 | Professional | 53 · Discontinued | $10.47 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $11.22 Typical High $12.30 | Professional | 55 · Aftercare only | $7.76 | $11.22 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.41 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.25 | $7.41 | $8.13 |
Where Kansas sits
The same service costs 4.3 times more in Hawaii 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· 15th of 51
$79.43
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.