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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $165.96 | Professional | None | $104.71 | $151.36 | $165.96 |
BCBS Kansas Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $154.88 | Facility | None | $147.91 | $154.88 | $154.88 |
BCBS Kansas Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $158.49 Typical High $891.25 | Facility | None | $104.71 | $158.49 | $891.25 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $977.24 | Professional | None | $66.07 | $102.33 | $977.24 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $234.42 | Facility | None | $199.53 | $199.53 | $234.42 |
United Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $125.89 | Professional | None | $64.57 | $95.50 | $125.89 |
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 $52.48 Median $75.86 Typical High $83.18 | Professional | 52 · Reduced service | $52.48 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $30.20 Typical High $33.11 | Professional | 53 · Discontinued | $21.38 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $22.91 Typical High $24.55 | Professional | 55 · Aftercare only | $15.85 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.14 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.47 | $15.14 | $16.60 |
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
$155
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.