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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $38.90 Typical High $41.69 | Professional | None | $26.92 | $38.90 | $41.69 |
BCBS Kansas Setting Facility Modifier None Typical Low $11.75 Median $12.30 Typical High $12.59 | Facility | None | $11.75 | $12.30 | $12.59 |
BCBS Kansas Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $40.74 Typical High $229.09 | Facility | None | $26.30 | $40.74 | $229.09 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $26.30 Typical High $245.47 | Professional | None | $16.98 | $26.30 | $245.47 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Facility | None | $50.12 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $16.22 Median $24.55 Typical High $32.36 | Professional | None | $16.22 | $24.55 | $32.36 |
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 $13.49 Median $19.05 Typical High $20.89 | Professional | 52 · Reduced service | $13.49 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $7.76 Typical High $8.32 | Professional | 53 · Discontinued | $5.37 | $7.76 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $5.75 Typical High $6.31 | Professional | 55 · Aftercare only | $3.98 | $5.75 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $3.89 Typical High $4.17 | Professional | 56 · Pre-op care only | $2.69 | $3.89 | $4.17 |
Where Kansas sits
The same service costs 3.1 times more in Montana 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
$16.98
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.