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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $47.86 Typical High $52.48 | Professional | None | $33.11 | $47.86 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
BCBS Kansas Setting Facility Modifier None Typical Low $58.88 Median $61.66 Typical High $61.66 | Facility | None | $58.88 | $61.66 | $61.66 |
BCBS Kansas Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $50.12 Typical High $331.13 | Facility | None | $33.11 | $50.12 | $331.13 |
Medica Setting Professional Modifier None Typical Low $23.44 Median $34.67 Typical High $524.81 | Professional | None | $23.44 | $34.67 | $524.81 |
United Setting Facility Modifier None Typical Low $40.74 Median $52.48 Typical High $83.18 | Facility | None | $40.74 | $52.48 | $83.18 |
United Setting Professional Modifier None Typical Low $19.95 Median $30.20 Typical High $40.74 | Professional | None | $19.95 | $30.20 | $40.74 |
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 $16.60 Median $23.99 Typical High $26.30 | Professional | 52 · Reduced service | $16.60 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $9.55 Typical High $10.47 | Professional | 53 · Discontinued | $6.61 | $9.55 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $7.24 Typical High $7.76 | Professional | 55 · Aftercare only | $5.01 | $7.24 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $4.79 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.31 | $4.79 | $5.25 |
Where Kansas sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 13th of 51
$58.88
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.