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 $4.07 Median $50.12 Typical High $60.26 | Facility | None | $4.07 | $50.12 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $52.48 Typical High $57.54 | Professional | None | $37.15 | $52.48 | $57.54 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $58.88 | Professional | None | $50.12 | $51.29 | $58.88 |
BCBS Kansas Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $77.62 | Facility | None | $74.13 | $74.13 | $77.62 |
BCBS Kansas Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | None | $33.11 | $33.11 | $45.71 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $54.95 Typical High $354.81 | Facility | None | $36.31 | $54.95 | $354.81 |
Medica Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $501.19 | Professional | None | $25.12 | $38.02 | $501.19 |
United Setting Facility Modifier None Typical Low $43.65 Median $52.48 Typical High $89.13 | Facility | None | $43.65 | $52.48 | $89.13 |
United Setting Professional Modifier None Typical Low $22.39 Median $33.11 Typical High $44.67 | Professional | None | $22.39 | $33.11 | $44.67 |
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 $18.62 Median $26.30 Typical High $28.84 | Professional | 52 · Reduced service | $18.62 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $10.72 Typical High $11.48 | Professional | 53 · Discontinued | $7.41 | $10.72 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $7.94 Typical High $8.71 | Professional | 55 · Aftercare only | $5.50 | $7.94 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.25 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.72 | $5.25 | $5.75 |
Where Kansas sits
The same service costs 3.8 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· 13th of 51
$60.26
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.