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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $194.98 | Professional | None | $134.90 | $190.55 | $194.98 |
BCBS Kansas Setting Facility Modifier None Typical Low $295.12 Median $309.03 Typical High $309.03 | Facility | None | $295.12 | $309.03 | $309.03 |
BCBS Kansas Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | None | $117.49 | $117.49 | $162.18 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $218.78 Typical High $1,318.26 | Facility | None | $134.90 | $218.78 | $1,318.26 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $1,698.24 | Professional | None | $109.65 | $173.78 | $1,698.24 |
United Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $354.81 | Facility | None | $104.71 | $128.82 | $354.81 |
United Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $199.53 | Professional | None | $85.11 | $128.82 | $199.53 |
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 $67.61 Median $95.50 Typical High $97.72 | Professional | 52 · Reduced service | $67.61 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $38.02 Typical High $38.90 | Professional | 53 · Discontinued | $26.92 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $19.95 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.05 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.49 | $19.05 | $19.50 |
Where Kansas sits
The same service costs 2.8 times more in Minnesota 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· 4th of 51
$295
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.