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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $165.96 | Professional | None | $107.15 | $154.88 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
BCBS Kansas Setting Facility Modifier None Typical Low $173.78 Median $181.97 Typical High $181.97 | Facility | None | $173.78 | $181.97 | $181.97 |
BCBS Kansas Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $162.18 Typical High $933.25 | Facility | None | $104.71 | $162.18 | $933.25 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $1,000.00 | Professional | None | $69.18 | $107.15 | $1,000.00 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $245.47 | Facility | None | $97.72 | $97.72 | $245.47 |
United Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $128.82 | Professional | None | $64.57 | $97.72 | $128.82 |
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 $53.70 Median $75.86 Typical High $83.18 | Professional | 52 · Reduced service | $53.70 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $30.90 Typical High $33.11 | Professional | 53 · Discontinued | $21.38 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $22.91 Typical High $25.12 | Professional | 55 · Aftercare only | $15.85 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.49 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.72 | $15.49 | $16.60 |
Where Kansas sits
The same service costs 2.3 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· 10th of 51
$174
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.