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 $10.96 Median $20.89 Typical High $22.91 | Facility | None | $10.96 | $20.89 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $20.89 Typical High $20.89 | Professional | None | $10.00 | $20.89 | $20.89 |
Ambetter Setting Professional Modifier None Typical Low $18.62 Median $20.89 Typical High $21.88 | Professional | None | $18.62 | $20.89 | $21.88 |
BCBS Kansas Setting Facility Modifier None Typical Low $7.76 Median $8.13 Typical High $8.13 | Facility | None | $7.76 | $8.13 | $8.13 |
BCBS Kansas Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $25.12 Typical High $32.36 | Professional | None | $16.60 | $25.12 | $32.36 |
Medica Setting Facility Modifier None Typical Low $14.79 Median $23.99 Typical High $70.79 | Facility | None | $14.79 | $23.99 | $70.79 |
Medica Setting Professional Modifier None Typical Low $14.13 Median $20.89 Typical High $30.90 | Professional | None | $14.13 | $20.89 | $30.90 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $134.90 | Facility | None | $85.11 | $85.11 | $134.90 |
United Setting Professional Modifier None Typical Low $14.13 Median $20.89 Typical High $35.48 | Professional | None | $14.13 | $20.89 | $35.48 |
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 $5.01 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $5.01 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $2.00 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $1.51 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.00 | $2.04 | $2.04 |
Where Kansas sits
The same service costs 5.4 times more in Vermont than in Kansas. 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· 51st of 51
$14.13
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.