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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $16.22 Typical High $16.60 | Professional | None | $11.48 | $16.22 | $16.60 |
BCBS Kansas Setting Facility Modifier None Typical Low $13.49 Median $14.13 Typical High $14.13 | Facility | None | $13.49 | $14.13 | $14.13 |
BCBS Kansas Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Medica Setting Facility Modifier None Typical Low $11.48 Median $18.62 Typical High $102.33 | Facility | None | $11.48 | $18.62 | $102.33 |
Medica Setting Professional Modifier None Typical Low $9.33 Median $14.13 Typical High $125.89 | Professional | None | $9.33 | $14.13 | $125.89 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.88 Typical High $25.70 | Facility | None | $12.59 | $12.88 | $25.70 |
United Setting Professional Modifier None Typical Low $7.24 Median $10.96 Typical High $14.45 | Professional | None | $7.24 | $10.96 | $14.45 |
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 $5.75 Median $8.13 Typical High $8.32 | Professional | 52 · Reduced service | $5.75 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $3.24 Typical High $3.31 | Professional | 53 · Discontinued | $2.29 | $3.24 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $1.70 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.62 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.12 | $1.62 | $1.66 |
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· 20th of 51
$14.79
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.