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 $33.11 Median $33.11 Typical High $48.98 | Facility | None | $33.11 | $33.11 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $44.67 Typical High $48.98 | Professional | None | $30.90 | $44.67 | $48.98 |
BCBS Kansas Setting Facility Modifier None Typical Low $17.38 Median $18.20 Typical High $18.20 | Facility | None | $17.38 | $18.20 | $18.20 |
BCBS Kansas Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | None | $23.99 | $23.99 | $33.11 |
Medica Setting Facility Modifier None Typical Low $30.90 Median $46.77 Typical High $263.03 | Facility | None | $30.90 | $46.77 | $263.03 |
Medica Setting Professional Modifier None Typical Low $19.50 Median $30.20 Typical High $288.40 | Professional | None | $19.50 | $30.20 | $288.40 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Facility | None | $58.88 | $58.88 | $69.18 |
United Setting Professional Modifier None Typical Low $18.62 Median $28.18 Typical High $37.15 | Professional | None | $18.62 | $28.18 | $37.15 |
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 $15.49 Median $22.39 Typical High $24.55 | Professional | 52 · Reduced service | $15.49 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $8.91 Typical High $9.77 | Professional | 53 · Discontinued | $6.17 | $8.91 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $6.76 Typical High $7.24 | Professional | 55 · Aftercare only | $4.68 | $6.76 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.47 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.09 | $4.47 | $4.79 |
Where Kansas sits
The same service costs 2.6 times more in Montana than in Kansas. 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· 51st of 51
$23.44
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.