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 $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $23.44 Typical High $23.44 | Professional | None | $16.22 | $23.44 | $23.44 |
BCBS Kansas Setting Facility Modifier None Typical Low $23.44 Median $24.55 Typical High $24.55 | Facility | None | $23.44 | $24.55 | $24.55 |
BCBS Kansas Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | None | $21.38 | $21.38 | $25.12 |
Medica Setting Facility Modifier None Typical Low $16.60 Median $26.30 Typical High $134.90 | Facility | None | $16.60 | $26.30 | $134.90 |
Medica Setting Professional Modifier None Typical Low $13.49 Median $20.89 Typical High $158.49 | Professional | None | $13.49 | $20.89 | $158.49 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $38.90 | Facility | None | $32.36 | $32.36 | $38.90 |
United Setting Professional Modifier None Typical Low $10.47 Median $15.85 Typical High $21.88 | Professional | None | $10.47 | $15.85 | $21.88 |
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 $8.13 Median $11.75 Typical High $11.75 | Professional | 52 · Reduced service | $8.13 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $3.31 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $3.47 Typical High $3.55 | Professional | 55 · Aftercare only | $2.45 | $3.47 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $2.34 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.62 | $2.34 | $2.34 |
Where Kansas sits
The same service costs 2.1 times more in Minnesota than in Washington, DC. 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· 24th of 51
$24.55
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.