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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $39.81 Typical High $43.65 | Professional | None | $27.54 | $39.81 | $43.65 |
BCBS Kansas Setting Facility Modifier None Typical Low $38.90 Median $39.81 Typical High $40.74 | Facility | None | $38.90 | $39.81 | $40.74 |
BCBS Kansas Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
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 $27.54 Median $41.69 Typical High $234.42 | Facility | None | $27.54 | $41.69 | $234.42 |
Medica Setting Professional Modifier None Typical Low $17.38 Median $26.92 Typical High $257.04 | Professional | None | $17.38 | $26.92 | $257.04 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $61.66 | Facility | None | $52.48 | $52.48 | $61.66 |
United Setting Professional Modifier None Typical Low $16.60 Median $25.12 Typical High $33.11 | Professional | None | $16.60 | $25.12 | $33.11 |
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 $13.80 Median $19.95 Typical High $21.38 | Professional | 52 · Reduced service | $13.80 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $7.94 Typical High $8.71 | Professional | 53 · Discontinued | $5.50 | $7.94 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $6.03 Typical High $6.46 | Professional | 55 · Aftercare only | $4.17 | $6.03 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $3.98 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.75 | $3.98 | $4.37 |
Where Kansas sits
The same service costs 2.2 times more in Montana than in Arizona. 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
$40.74
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.