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 $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $154.88 | Professional | None | $97.72 | $141.25 | $154.88 |
BCBS Kansas Setting Facility Modifier None Typical Low $138.04 Median $144.54 Typical High $144.54 | Facility | None | $138.04 | $144.54 | $144.54 |
BCBS Kansas Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None | $74.13 | $74.13 | $102.33 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $147.91 Typical High $741.31 | Facility | None | $97.72 | $147.91 | $741.31 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $912.01 | Professional | None | $60.26 | $95.50 | $912.01 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $190.55 | Facility | None | $87.10 | $87.10 | $190.55 |
United Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $114.82 | Professional | None | $53.70 | $89.13 | $114.82 |
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 $48.98 Median $70.79 Typical High $77.62 | Professional | 52 · Reduced service | $48.98 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $28.18 Typical High $30.90 | Professional | 53 · Discontinued | $19.95 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $21.38 Typical High $22.91 | Professional | 55 · Aftercare only | $14.79 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.13 Typical High $15.49 | Professional | 56 · Pre-op care only | $9.77 | $14.13 | $15.49 |
Where Kansas sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 12th of 51
$145
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.