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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $48.98 Typical High $53.70 | Professional | None | $34.67 | $48.98 | $53.70 |
BCBS Kansas Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $52.48 | Facility | None | $50.12 | $52.48 | $52.48 |
BCBS Kansas Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $51.29 Typical High $309.03 | Facility | None | $33.88 | $51.29 | $309.03 |
Medica Setting Professional Modifier None Typical Low $22.39 Median $34.67 Typical High $389.05 | Professional | None | $22.39 | $34.67 | $389.05 |
United Setting Facility Modifier None Typical Low $35.48 Median $38.02 Typical High $79.43 | Facility | None | $35.48 | $38.02 | $79.43 |
United Setting Professional Modifier None Typical Low $20.89 Median $30.90 Typical High $41.69 | Professional | None | $20.89 | $30.90 | $41.69 |
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 $16.98 Median $24.55 Typical High $26.92 | Professional | 52 · Reduced service | $16.98 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $9.77 Typical High $10.72 | Professional | 53 · Discontinued | $6.92 | $9.77 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $7.41 Typical High $7.94 | Professional | 55 · Aftercare only | $5.13 | $7.41 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.90 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.47 | $4.90 | $5.37 |
Where Kansas sits
The same service costs 3.0 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· 14th of 51
$52.48
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.