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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $346.74 | Professional | None | $245.47 | $346.74 | $346.74 |
BCBS Kansas Setting Facility Modifier None Typical Low $363.08 Median $380.19 Typical High $380.19 | Facility | None | $363.08 | $380.19 | $380.19 |
BCBS Kansas Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $389.05 Typical High $1,862.09 | Facility | None | $245.47 | $389.05 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $2,630.27 | Professional | None | $173.78 | $269.15 | $2,630.27 |
United Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $478.63 | Facility | None | $234.42 | $281.84 | $478.63 |
United Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $295.12 | Professional | None | $144.54 | $234.42 | $295.12 |
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 $120.23 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $120.23 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $69.18 Typical High $70.79 | Professional | 53 · Discontinued | $48.98 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $51.29 Typical High $52.48 | Professional | 55 · Aftercare only | $36.31 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $24.55 | $34.67 | $34.67 |
Where Kansas sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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
$372
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.