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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $57.54 | Professional | None | $39.81 | $56.23 | $57.54 |
BCBS Kansas Setting Facility Modifier None Typical Low $56.23 Median $58.88 Typical High $58.88 | Facility | None | $56.23 | $58.88 | $58.88 |
BCBS Kansas Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $63.10 Typical High $354.81 | Facility | None | $39.81 | $63.10 | $354.81 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $50.12 Typical High $380.19 | Professional | None | $32.36 | $50.12 | $380.19 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $93.33 | Facility | None | $79.43 | $79.43 | $93.33 |
United Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $52.48 | Professional | None | $25.12 | $38.02 | $52.48 |
2 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 55 · Aftercare only Typical Low $5.89 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $5.89 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.62 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.98 | $5.62 | $5.75 |
Where Kansas sits
The same service costs 2.2 times more in Montana than in West Virginia. 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· 16th of 51
$58.88
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.