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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $18.62 Typical High $19.05 | Professional | None | $13.18 | $18.62 | $19.05 |
BCBS Kansas Setting Facility Modifier None Typical Low $28.84 Median $30.20 Typical High $30.90 | Facility | None | $28.84 | $30.20 | $30.90 |
BCBS Kansas Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
Medica Setting Facility Modifier None Typical Low $13.18 Median $21.38 Typical High $131.83 | Facility | None | $13.18 | $21.38 | $131.83 |
Medica Setting Professional Modifier None Typical Low $10.72 Median $16.98 Typical High $158.49 | Professional | None | $10.72 | $16.98 | $158.49 |
United Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $33.88 | Facility | None | $12.88 | $16.22 | $33.88 |
United Setting Professional Modifier None Typical Low $8.51 Median $12.59 Typical High $18.62 | Professional | None | $8.51 | $12.59 | $18.62 |
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 $6.61 Median $9.33 Typical High $9.55 | Professional | 52 · Reduced service | $6.61 | $9.33 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $3.80 Typical High $3.80 | Professional | 53 · Discontinued | $2.63 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.82 Typical High $2.88 | Professional | 55 · Aftercare only | $2.00 | $2.82 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.86 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.32 | $1.86 | $1.91 |
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· 3rd of 51
$28.84
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.