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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $64.57 Typical High $69.18 | Professional | None | $44.67 | $64.57 | $69.18 |
BCBS Kansas Setting Facility Modifier None Typical Low $102.33 Median $107.15 Typical High $109.65 | Facility | None | $102.33 | $107.15 | $109.65 |
BCBS Kansas Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Medica Setting Facility Modifier None Typical Low $43.65 Median $67.61 Typical High $363.08 | Facility | None | $43.65 | $67.61 | $363.08 |
Medica Setting Professional Modifier None Typical Low $26.92 Median $43.65 Typical High $489.78 | Professional | None | $26.92 | $43.65 | $489.78 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $89.13 | Facility | None | $43.65 | $43.65 | $89.13 |
United Setting Professional Modifier None Typical Low $25.70 Median $40.74 Typical High $51.29 | Professional | None | $25.70 | $40.74 | $51.29 |
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 $22.39 Median $32.36 Typical High $34.67 | Professional | 52 · Reduced service | $22.39 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $12.88 Typical High $13.80 | Professional | 53 · Discontinued | $8.91 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $9.55 Typical High $10.47 | Professional | 55 · Aftercare only | $6.61 | $9.55 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.46 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.47 | $6.46 | $6.92 |
Where Kansas sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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· 3rd of 51
$91.20
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.