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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $51.29 Typical High $56.23 | Professional | None | $36.31 | $51.29 | $56.23 |
BCBS Kansas Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $53.70 | Facility | None | $50.12 | $52.48 | $53.70 |
BCBS Kansas Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $37.15 | Professional | None | $26.92 | $26.92 | $37.15 |
Medica Setting Facility Modifier None Typical Low $35.48 Median $53.70 Typical High $309.03 | Facility | None | $35.48 | $53.70 | $309.03 |
Medica Setting Professional Modifier None Typical Low $22.39 Median $34.67 Typical High $331.13 | Professional | None | $22.39 | $34.67 | $331.13 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $79.43 | Facility | None | $67.61 | $67.61 | $79.43 |
United Setting Professional Modifier None Typical Low $21.88 Median $32.36 Typical High $42.66 | Professional | None | $21.88 | $32.36 | $42.66 |
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 $18.20 Median $25.70 Typical High $28.18 | Professional | 52 · Reduced service | $18.20 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $10.47 Typical High $11.22 | Professional | 53 · Discontinued | $7.24 | $10.47 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.76 Typical High $8.51 | Professional | 55 · Aftercare only | $5.37 | $7.76 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $5.13 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.63 | $5.13 | $5.62 |
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· 14th of 51
$53.70
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.