How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $4.47 Median $5.25 Typical High $9.33 | Facility | None | $4.47 | $5.25 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $9.33 Typical High $9.33 | Professional | None | $4.47 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.24 Median $4.68 Typical High $4.68 | Professional | 52 · Reduced service | $2.24 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $1.86 Typical High $1.86 | Professional | 53 · Discontinued | $0.89 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $1.41 Typical High $1.41 | Professional | 55 · Aftercare only | $0.68 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.93 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.45 | $0.93 | $0.93 |
Ambetter Setting Professional Modifier None Typical Low $3.72 Median $4.37 Typical High $5.13 | Professional | None | $3.72 | $4.37 | $5.13 |
BCBS Kansas Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $6.17 | Professional | None | $5.01 | $5.01 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $7.08 | Professional | None | $3.02 | $3.98 | $7.08 |
Medica Setting Facility Modifier None Typical Low $4.47 Median $6.76 Typical High $10.00 | Facility | None | $4.47 | $6.76 | $10.00 |
Medica Setting Professional Modifier None Typical Low $6.31 Median $29.51 Typical High $29.51 | Professional | None | $6.31 | $29.51 | $29.51 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $69.18 | Facility | None | $43.65 | $43.65 | $69.18 |
United Setting Professional Modifier None Typical Low $4.79 Median $6.46 Typical High $12.02 | Professional | None | $4.79 | $6.46 | $12.02 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $3.80 Median $4.47 Typical High $5.62 | Professional | 59 · Distinct service | $3.80 | $4.47 | $5.62 |
Where Kansas sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 30th of 51
$5.01
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.