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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $131.83 | Professional | None | $85.11 | $120.23 | $131.83 |
BCBS Kansas Setting Facility Modifier None Typical Low $74.13 Median $77.62 Typical High $77.62 | Facility | None | $74.13 | $77.62 | $77.62 |
BCBS Kansas Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $125.89 Typical High $812.83 | Facility | None | $83.18 | $125.89 | $812.83 |
Medica Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $1,000.00 | Professional | None | $57.54 | $87.10 | $1,000.00 |
United Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $204.17 | Facility | None | $95.50 | $100.00 | $204.17 |
United Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $102.33 | Professional | None | $51.29 | $75.86 | $102.33 |
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 $42.66 Median $60.26 Typical High $66.07 | Professional | 52 · Reduced service | $42.66 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $23.99 Typical High $26.30 | Professional | 53 · Discontinued | $16.98 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $18.20 Typical High $19.95 | Professional | 55 · Aftercare only | $12.59 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.02 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.51 | $12.02 | $13.18 |
Where Kansas sits
The same service costs 3.2 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· 30th of 51
$95.50
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.