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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $75.86 | Professional | None | $46.77 | $69.18 | $75.86 |
BCBS Kansas Setting Facility Modifier None Typical Low $20.89 Median $21.88 Typical High $21.88 | Facility | None | $20.89 | $21.88 | $21.88 |
BCBS Kansas Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $72.44 Typical High $416.87 | Facility | None | $47.86 | $72.44 | $416.87 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $46.77 Typical High $446.68 | Professional | None | $30.20 | $46.77 | $446.68 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $107.15 | Facility | None | $91.20 | $91.20 | $107.15 |
United Setting Professional Modifier None Typical Low $29.51 Median $43.65 Typical High $57.54 | Professional | None | $29.51 | $43.65 | $57.54 |
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 $24.55 Median $34.67 Typical High $38.02 | Professional | 52 · Reduced service | $24.55 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $14.13 Typical High $15.14 | Professional | 53 · Discontinued | $9.77 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.47 Typical High $11.48 | Professional | 55 · Aftercare only | $7.24 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.92 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.90 | $6.92 | $7.59 |
Where Kansas sits
The same service costs 3.0 times more in Hawaii 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
$30.20
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.