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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $234.42 | Professional | None | $151.36 | $213.80 | $234.42 |
BCBS Kansas Setting Facility Modifier None Typical Low $218.78 Median $229.09 Typical High $229.09 | Facility | None | $218.78 | $229.09 | $229.09 |
BCBS Kansas Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $229.09 Typical High $1,445.44 | Facility | None | $147.91 | $229.09 | $1,445.44 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $2,344.23 | Professional | None | $104.71 | $154.88 | $2,344.23 |
United Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $371.54 | Facility | None | $181.97 | $229.09 | $371.54 |
United Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $181.97 | Professional | None | $91.20 | $138.04 | $181.97 |
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 $75.86 Median $107.15 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $43.65 Typical High $46.77 | Professional | 53 · Discontinued | $30.20 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $32.36 Typical High $35.48 | Professional | 55 · Aftercare only | $22.39 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.38 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.14 | $21.38 | $23.44 |
Where Kansas sits
The same service costs 4.7 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
$229
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.