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 $199.53 Median $199.53 Typical High $234.42 | Facility | None | $199.53 | $199.53 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $199.53 | Professional | None | $138.04 | $194.98 | $199.53 |
BCBS Kansas Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $288.40 | Facility | None | $275.42 | $275.42 | $288.40 |
BCBS Kansas Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $213.80 Typical High $1,148.15 | Facility | None | $138.04 | $213.80 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $1,318.26 | Professional | None | $112.20 | $177.83 | $1,318.26 |
United Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $181.97 | Professional | None | $87.10 | $131.83 | $181.97 |
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 $20.42 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $20.42 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.50 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.80 | $19.50 | $19.95 |
Where Kansas sits
The same service costs 2.6 times more in Montana than in New York. 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
$275
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.