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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $112.20 | Professional | None | $72.44 | $102.33 | $112.20 |
BCBS Kansas Setting Facility Modifier None Typical Low $104.71 Median $109.65 Typical High $109.65 | Facility | None | $104.71 | $109.65 | $109.65 |
BCBS Kansas Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $107.15 Typical High $537.03 | Facility | None | $70.79 | $107.15 | $537.03 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $67.61 Typical High $676.08 | Professional | None | $42.66 | $67.61 | $676.08 |
United Setting Facility Modifier None Typical Low $46.77 Median $61.66 Typical High $138.04 | Facility | None | $46.77 | $61.66 | $138.04 |
United Setting Professional Modifier None Typical Low $38.90 Median $64.57 Typical High $83.18 | Professional | None | $38.90 | $64.57 | $83.18 |
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 $35.48 Median $51.29 Typical High $56.23 | Professional | 52 · Reduced service | $35.48 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $20.42 Typical High $22.39 | Professional | 53 · Discontinued | $14.45 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $15.49 Typical High $16.98 | Professional | 55 · Aftercare only | $10.72 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $10.23 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.24 | $10.23 | $11.22 |
Where Kansas sits
The same service costs 2.7 times more in Hawaii than in Delaware. 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· 7th of 51
$110
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.