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 $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $40.74 Typical High $44.67 | Professional | None | $28.84 | $40.74 | $44.67 |
BCBS Kansas Setting Facility Modifier None Typical Low $38.90 Median $40.74 Typical High $40.74 | Facility | None | $38.90 | $40.74 | $40.74 |
BCBS Kansas Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $42.66 Typical High $239.88 | Facility | None | $28.18 | $42.66 | $239.88 |
Medica Setting Professional Modifier None Typical Low $17.78 Median $27.54 Typical High $263.03 | Professional | None | $17.78 | $27.54 | $263.03 |
United Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $63.10 | Facility | None | $53.70 | $53.70 | $63.10 |
United Setting Professional Modifier None Typical Low $17.38 Median $25.70 Typical High $33.88 | Professional | None | $17.38 | $25.70 | $33.88 |
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 $14.13 Median $20.42 Typical High $22.39 | Professional | 52 · Reduced service | $14.13 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $8.13 Typical High $8.91 | Professional | 53 · Discontinued | $5.75 | $8.13 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $6.17 Typical High $6.76 | Professional | 55 · Aftercare only | $4.27 | $6.17 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $4.07 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.82 | $4.07 | $4.47 |
Where Kansas sits
The same service costs 2.1 times more in Montana than in New Jersey. 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· 15th of 51
$40.74
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.