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 $31.62 Median $67.61 Typical High $67.61 | Professional | None | $31.62 | $67.61 | $67.61 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $45.71 Typical High $87.10 | Professional | None | $39.81 | $45.71 | $87.10 |
BCBS Kansas Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $56.23 | Facility | None | $53.70 | $53.70 | $56.23 |
BCBS Kansas Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Medica Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $104.71 | Facility | None | $42.66 | $42.66 | $104.71 |
Medica Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $724.44 | Professional | None | $21.88 | $25.70 | $724.44 |
United Setting Professional Modifier None Typical Low $16.98 Median $25.70 Typical High $32.36 | Professional | None | $16.98 | $25.70 | $32.36 |
5 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 $15.85 Median $33.11 Typical High $33.88 | Professional | 52 · Reduced service | $15.85 | $33.11 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $6.31 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $50.12 Typical High $51.29 | Professional | 54 · Surgery only | $23.44 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $10.00 Typical High $10.23 | Professional | 55 · Aftercare only | $4.68 | $10.00 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.16 | $6.76 | $6.76 |
Where Kansas sits
The same service costs 2.6 times more in Hawaii 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· 24th of 51
$35.48
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.