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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $83.18 | Professional | None | $53.70 | $77.62 | $83.18 |
BCBS Kansas Setting Facility Modifier None Typical Low $44.67 Median $45.71 Typical High $46.77 | Facility | None | $44.67 | $45.71 | $46.77 |
BCBS Kansas Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $81.28 Typical High $457.09 | Facility | None | $52.48 | $81.28 | $457.09 |
Medica Setting Professional Modifier None Typical Low $33.88 Median $52.48 Typical High $489.78 | Professional | None | $33.88 | $52.48 | $489.78 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $120.23 | Facility | None | $102.33 | $102.33 | $120.23 |
United Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $64.57 | Professional | None | $32.36 | $48.98 | $64.57 |
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 $26.92 Median $38.90 Typical High $41.69 | Professional | 52 · Reduced service | $26.92 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $15.49 Typical High $16.98 | Professional | 53 · Discontinued | $10.72 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $11.48 Typical High $12.59 | Professional | 55 · Aftercare only | $8.13 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.76 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.37 | $7.76 | $8.32 |
Where Kansas sits
The same service costs 2.0 times more in Hawaii than in West Virginia. 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· 24th of 51
$58.88
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.