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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $36.31 Typical High $38.90 | Professional | None | $25.12 | $36.31 | $38.90 |
BCBS Kansas Setting Facility Modifier None Typical Low $27.54 Median $28.18 Typical High $28.84 | Facility | None | $27.54 | $28.18 | $28.84 |
BCBS Kansas Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
Medica Setting Facility Modifier None Typical Low $24.55 Median $38.02 Typical High $213.80 | Facility | None | $24.55 | $38.02 | $213.80 |
Medica Setting Professional Modifier None Typical Low $15.85 Median $24.55 Typical High $229.09 | Professional | None | $15.85 | $24.55 | $229.09 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $56.23 | Facility | None | $47.86 | $47.86 | $56.23 |
United Setting Professional Modifier None Typical Low $15.14 Median $22.91 Typical High $30.20 | Professional | None | $15.14 | $22.91 | $30.20 |
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 $12.59 Median $18.20 Typical High $19.50 | Professional | 52 · Reduced service | $12.59 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $7.24 Typical High $7.94 | Professional | 53 · Discontinued | $5.01 | $7.24 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $5.37 Typical High $5.89 | Professional | 55 · Aftercare only | $3.80 | $5.37 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.63 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.51 | $3.63 | $3.89 |
Where Kansas sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 20th of 51
$30.90
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.