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 $37.15 Median $37.15 Typical High $66.07 | Facility | None | $37.15 | $37.15 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $61.66 Typical High $66.07 | Professional | None | $40.74 | $61.66 | $66.07 |
BCBS Kansas Setting Facility Modifier None Typical Low $61.66 Median $64.57 Typical High $64.57 | Facility | None | $61.66 | $64.57 | $64.57 |
BCBS Kansas Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $64.57 Typical High $354.81 | Facility | None | $41.69 | $64.57 | $354.81 |
Medica Setting Professional Modifier None Typical Low $25.70 Median $41.69 Typical High $426.58 | Professional | None | $25.70 | $41.69 | $426.58 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $89.13 | Facility | None | $43.65 | $43.65 | $89.13 |
United Setting Professional Modifier None Typical Low $25.12 Median $38.90 Typical High $50.12 | Professional | None | $25.12 | $38.90 | $50.12 |
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 $21.38 Median $30.90 Typical High $33.11 | Professional | 52 · Reduced service | $21.38 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $12.30 Typical High $13.49 | Professional | 53 · Discontinued | $8.51 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $9.12 Typical High $10.00 | Professional | 55 · Aftercare only | $6.46 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.17 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.27 | $6.17 | $6.61 |
Where Kansas sits
The same service costs 3.1 times more in Hawaii than in Florida. 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· 9th of 51
$64.57
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.