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 $0.71 Median $0.71 Typical High $0.71 | Facility | None | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier None Typical Low $0.38 Median $0.69 Typical High $0.71 | Professional | None | $0.38 | $0.69 | $0.71 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
BCBS Kansas Setting Facility Modifier None Typical Low $1.38 Median $1.45 Typical High $1.45 | Facility | None | $1.38 | $1.45 | $1.45 |
BCBS Kansas Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Medica Setting Facility Modifier None Typical Low $0.46 Median $0.46 Typical High $0.68 | Facility | None | $0.46 | $0.46 | $0.68 |
Medica Setting Professional Modifier None Typical Low $0.26 Median $0.31 Typical High $4.27 | Professional | None | $0.26 | $0.31 | $4.27 |
United Setting Professional Modifier None Typical Low $0.21 Median $0.31 Typical High $0.40 | Professional | None | $0.21 | $0.31 | $0.40 |
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 $0.19 Median $0.35 Typical High $0.35 | Professional | 52 · Reduced service | $0.19 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.08 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.10 Typical High $0.11 | Professional | 55 · Aftercare only | $0.06 | $0.10 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.04 | $0.07 | $0.07 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.04 Median $0.07 Typical High $0.07 | Professional | RR · Rental | $0.04 | $0.07 | $0.07 |
Where Kansas sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 19th of 51
$0.45
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.