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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $109.65 | Professional | None | $69.18 | $100.00 | $109.65 |
BCBS Kansas Setting Facility Modifier None Typical Low $97.72 Median $100.00 Typical High $102.33 | Facility | None | $97.72 | $100.00 | $102.33 |
BCBS Kansas Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $104.71 Typical High $588.84 | Facility | None | $69.18 | $104.71 | $588.84 |
Medica Setting Professional Modifier None Typical Low $43.65 Median $67.61 Typical High $645.65 | Professional | None | $43.65 | $67.61 | $645.65 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $154.88 | Facility | None | $131.83 | $131.83 | $154.88 |
United Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $83.18 | Professional | None | $41.69 | $63.10 | $83.18 |
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 $34.67 Median $50.12 Typical High $54.95 | Professional | 52 · Reduced service | $34.67 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $19.95 Typical High $21.88 | Professional | 53 · Discontinued | $13.80 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $15.14 Typical High $16.22 | Professional | 55 · Aftercare only | $10.47 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.00 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.92 | $10.00 | $10.96 |
Where Kansas sits
The same service costs 2.6 times more in Hawaii 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
$102
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.