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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $398.11 | Professional | None | $275.42 | $398.11 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | None | $363.08 | $407.38 | $407.38 |
BCBS Kansas Setting Facility Modifier None Typical Low $549.54 Median $575.44 Typical High $575.44 | Facility | None | $549.54 | $575.44 | $575.44 |
BCBS Kansas Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $263.03 | Professional | None | $190.55 | $190.55 | $263.03 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $446.68 Typical High $2,290.87 | Facility | None | $281.84 | $446.68 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $2,691.53 | Professional | None | $199.53 | $309.03 | $2,691.53 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $549.54 | Facility | None | $263.03 | $263.03 | $549.54 |
United Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $338.84 | Professional | None | $165.96 | $269.15 | $338.84 |
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 $138.04 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $138.04 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $54.95 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $58.88 Typical High $60.26 | Professional | 55 · Aftercare only | $41.69 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $27.54 | $39.81 | $39.81 |
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· 3rd of 51
$550
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.