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 $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $32.36 Typical High $35.48 | Professional | None | $22.39 | $32.36 | $35.48 |
BCBS Kansas Setting Facility Modifier None Typical Low $31.62 Median $33.11 Typical High $33.11 | Facility | None | $31.62 | $33.11 | $33.11 |
BCBS Kansas Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
Medica Setting Facility Modifier None Typical Low $22.39 Median $33.88 Typical High $190.55 | Facility | None | $22.39 | $33.88 | $190.55 |
Medica Setting Professional Modifier None Typical Low $14.13 Median $21.88 Typical High $208.93 | Professional | None | $14.13 | $21.88 | $208.93 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $50.12 | Facility | None | $42.66 | $42.66 | $50.12 |
United Setting Professional Modifier None Typical Low $13.80 Median $20.42 Typical High $26.92 | Professional | None | $13.80 | $20.42 | $26.92 |
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 $11.22 Median $16.22 Typical High $17.78 | Professional | 52 · Reduced service | $11.22 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $6.46 Typical High $7.08 | Professional | 53 · Discontinued | $4.57 | $6.46 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $4.90 Typical High $5.37 | Professional | 55 · Aftercare only | $3.39 | $4.90 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $3.24 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.24 | $3.24 | $3.55 |
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· 15th of 51
$33.11
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.