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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $204.17 | Professional | None | $131.83 | $186.21 | $204.17 |
BCBS Kansas Setting Facility Modifier None Typical Low $177.83 Median $186.21 Typical High $186.21 | Facility | None | $177.83 | $186.21 | $186.21 |
BCBS Kansas Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $151.36 | Professional | None | $112.20 | $112.20 | $151.36 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $1,122.02 | Facility | None | $128.82 | $194.98 | $1,122.02 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $1,202.26 | Professional | None | $81.28 | $125.89 | $1,202.26 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $288.40 | Facility | None | $245.47 | $245.47 | $288.40 |
United Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $154.88 | Professional | None | $79.43 | $117.49 | $154.88 |
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 $66.07 Median $93.33 Typical High $102.33 | Professional | 52 · Reduced service | $66.07 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $38.02 Typical High $40.74 | Professional | 53 · Discontinued | $26.30 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.18 Typical High $30.90 | Professional | 55 · Aftercare only | $19.50 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $18.62 Typical High $20.42 | Professional | 56 · Pre-op care only | $13.18 | $18.62 | $20.42 |
Where Kansas sits
The same service costs 2.1 times more in Hawaii than in Utah. 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
$186
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.