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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $147.91 | Professional | None | $102.33 | $144.54 | $147.91 |
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 $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $162.18 Typical High $1,047.13 | Facility | None | $102.33 | $162.18 | $1,047.13 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $1,288.25 | Professional | None | $83.18 | $131.83 | $1,288.25 |
United Setting Facility Modifier None Typical Low $107.15 Median $131.83 Typical High $269.15 | Facility | None | $107.15 | $131.83 | $269.15 |
United Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $147.91 | Professional | None | $64.57 | $97.72 | $147.91 |
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 $51.29 Median $72.44 Typical High $74.13 | Professional | 52 · Reduced service | $51.29 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $28.84 Typical High $29.51 | Professional | 53 · Discontinued | $20.42 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $15.14 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.45 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.23 | $14.45 | $14.79 |
Where Kansas sits
The same service costs 3.0 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· 48th 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.