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 $85.11 Median $85.11 Typical High $89.13 | Facility | None | $85.11 | $85.11 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $85.11 | Professional | None | $53.70 | $77.62 | $85.11 |
BCBS Kansas Setting Facility Modifier None Typical Low $91.20 Median $95.50 Typical High $95.50 | Facility | None | $91.20 | $95.50 | $95.50 |
BCBS Kansas Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Medica Setting Facility Modifier None Typical Low $53.70 Median $77.62 Typical High $478.63 | Facility | None | $53.70 | $77.62 | $478.63 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $60.26 Typical High $524.81 | Professional | None | $37.15 | $60.26 | $524.81 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $131.83 | Facility | None | $72.44 | $72.44 | $131.83 |
United Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $67.61 | Professional | None | $32.36 | $48.98 | $67.61 |
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 $26.92 Median $38.90 Typical High $41.69 | Professional | 52 · Reduced service | $26.92 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $15.49 Typical High $16.98 | Professional | 53 · Discontinued | $10.72 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $11.48 Typical High $12.59 | Professional | 55 · Aftercare only | $8.13 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.76 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.37 | $7.76 | $8.51 |
Where Kansas sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 10th of 51
$91.20
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.