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 $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $323.59 | Professional | None | $194.98 | $316.23 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
BCBS Kansas Setting Facility Modifier None Typical Low $346.74 Median $363.08 Typical High $363.08 | Facility | None | $346.74 | $363.08 | $363.08 |
BCBS Kansas Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $354.81 Typical High $1,995.26 | Facility | None | $223.87 | $354.81 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $281.84 Typical High $2,187.76 | Professional | None | $181.97 | $281.84 | $2,187.76 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $512.86 | Facility | None | $186.21 | $229.09 | $512.86 |
United Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $316.23 | Professional | None | $141.25 | $213.80 | $316.23 |
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 $112.20 Median $158.49 Typical High $162.18 | Professional | 52 · Reduced service | $112.20 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $63.10 Typical High $64.57 | Professional | 53 · Discontinued | $44.67 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $33.11 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $31.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $22.39 | $31.62 | $32.36 |
Where Kansas sits
The same service costs 2.5 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
$347
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.