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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $36.31 Typical High $36.31 | Professional | None | $22.39 | $36.31 | $36.31 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
BCBS Kansas Setting Facility Modifier None Typical Low $42.66 Median $44.67 Typical High $44.67 | Facility | None | $42.66 | $44.67 | $44.67 |
BCBS Kansas Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $40.74 Typical High $229.09 | Facility | None | $25.70 | $40.74 | $229.09 |
Medica Setting Professional Modifier None Typical Low $20.42 Median $32.36 Typical High $316.23 | Professional | None | $20.42 | $32.36 | $316.23 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $60.26 | Facility | None | $16.22 | $29.51 | $60.26 |
United Setting Professional Modifier None Typical Low $16.22 Median $23.99 Typical High $36.31 | Professional | None | $16.22 | $23.99 | $36.31 |
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 $12.59 Median $17.78 Typical High $18.20 | Professional | 52 · Reduced service | $12.59 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $5.01 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $5.37 Typical High $5.50 | Professional | 55 · Aftercare only | $3.80 | $5.37 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.51 | $3.63 | $3.63 |
Where Kansas sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 13th of 51
$42.66
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.