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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $51.29 | Professional | None | $32.36 | $46.77 | $51.29 |
BCBS Kansas Setting Facility Modifier None Typical Low $37.15 Median $38.02 Typical High $38.90 | Facility | None | $37.15 | $38.02 | $38.90 |
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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
Medica Setting Facility Modifier None Typical Low $32.36 Median $48.98 Typical High $275.42 | Facility | None | $32.36 | $48.98 | $275.42 |
Medica Setting Professional Modifier None Typical Low $20.42 Median $31.62 Typical High $302.00 | Professional | None | $20.42 | $31.62 | $302.00 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $72.44 | Facility | None | $61.66 | $61.66 | $72.44 |
United Setting Professional Modifier None Typical Low $19.95 Median $29.51 Typical High $38.90 | Professional | None | $19.95 | $29.51 | $38.90 |
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 $16.22 Median $23.44 Typical High $25.70 | Professional | 52 · Reduced service | $16.22 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $9.33 Typical High $10.23 | Professional | 53 · Discontinued | $6.61 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $7.08 Typical High $7.59 | Professional | 55 · Aftercare only | $4.90 | $7.08 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.68 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.24 | $4.68 | $5.13 |
Where Kansas sits
The same service costs 2.6 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· 18th 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.