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 $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $933.25 | Professional | None | $602.56 | $870.96 | $933.25 |
BCBS Kansas Setting Facility Modifier None Typical Low $870.96 Median $912.01 Typical High $912.01 | Facility | None | $870.96 | $912.01 | $912.01 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $912.01 Typical High $5,128.61 | Facility | None | $588.84 | $912.01 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $6,165.95 | Professional | None | $371.54 | $588.84 | $6,165.95 |
United Setting Facility Modifier None Typical Low $575.44 Median $645.65 Typical High $1,318.26 | Facility | None | $575.44 | $645.65 | $1,318.26 |
United Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $707.95 | Professional | None | $363.08 | $549.54 | $707.95 |
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 $302.00 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $302.00 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $173.78 Typical High $186.21 | Professional | 53 · Discontinued | $120.23 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $89.13 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $87.10 Typical High $93.33 | Professional | 56 · Pre-op care only | $60.26 | $87.10 | $93.33 |
Where Kansas sits
The same service costs 2.6 times more in Hawaii 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· 13th of 51
$912
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.