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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $67.61 | Professional | None | $46.77 | $67.61 | $67.61 |
BCBS Kansas Setting Facility Modifier None Typical Low $134.90 Median $138.04 Typical High $141.25 | Facility | None | $134.90 | $138.04 | $141.25 |
BCBS Kansas Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
Medica Setting Facility Modifier None Typical Low $46.77 Median $75.86 Typical High $426.58 | Facility | None | $46.77 | $75.86 | $426.58 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $60.26 Typical High $457.09 | Professional | None | $38.02 | $60.26 | $457.09 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $109.65 | Facility | None | $44.67 | $44.67 | $109.65 |
United Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $61.66 | Professional | None | $30.20 | $44.67 | $61.66 |
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 $23.44 Median $33.11 Typical High $33.88 | Professional | 52 · Reduced service | $23.44 | $33.11 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $9.33 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.00 Typical High $10.23 | Professional | 55 · Aftercare only | $7.08 | $10.00 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.68 | $6.76 | $6.76 |
Where Kansas sits
The same service costs 2.8 times more in Kansas 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· 1st of 51
$107
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.