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 $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $21.88 Typical High $21.88 | Professional | None | $15.14 | $21.88 | $21.88 |
Ambetter Setting Professional Modifier None Typical Low $19.95 Median $22.39 Typical High $22.39 | Professional | None | $19.95 | $22.39 | $22.39 |
BCBS Kansas Setting Facility Modifier None Typical Low $36.31 Median $38.02 Typical High $38.90 | Facility | None | $36.31 | $38.02 | $38.90 |
BCBS Kansas Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | None | $13.49 | $13.49 | $18.62 |
Medica Setting Facility Modifier None Typical Low $15.49 Median $24.55 Typical High $141.25 | Facility | None | $15.49 | $24.55 | $141.25 |
Medica Setting Professional Modifier None Typical Low $12.30 Median $19.50 Typical High $162.18 | Professional | None | $12.30 | $19.50 | $162.18 |
United Setting Facility Modifier None Typical Low $14.45 Median $16.60 Typical High $36.31 | Facility | None | $14.45 | $16.60 | $36.31 |
United Setting Professional Modifier None Typical Low $9.77 Median $14.79 Typical High $20.42 | Professional | None | $9.77 | $14.79 | $20.42 |
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 $7.59 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $7.59 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $3.02 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $3.24 Typical High $3.31 | Professional | 55 · Aftercare only | $2.29 | $3.24 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.51 | $2.19 | $2.19 |
Where Kansas sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 2nd of 51
$34.67
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.