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 $3.16 Median $4.90 Typical High $4.90 | Facility | None | $3.16 | $4.90 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $4.79 Typical High $4.90 | Professional | None | $2.29 | $4.79 | $4.90 |
Ambetter Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
BCBS Kansas Setting Facility Modifier None Typical Low $1.95 Median $2.04 Typical High $2.04 | Facility | None | $1.95 | $2.04 | $2.04 |
BCBS Kansas Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Medica Setting Facility Modifier None Typical Low $2.82 Median $3.24 Typical High $4.07 | Facility | None | $2.82 | $3.24 | $4.07 |
Medica Setting Professional Modifier None Typical Low $1.70 Median $1.86 Typical High $21.88 | Professional | None | $1.70 | $1.86 | $21.88 |
United Setting Professional Modifier None Typical Low $1.23 Median $1.86 Typical High $2.40 | Professional | None | $1.23 | $1.86 | $2.40 |
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 $1.12 Median $2.40 Typical High $2.45 | Professional | 52 · Reduced service | $1.12 | $2.40 | $2.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.45 Median $0.98 Typical High $0.98 | Professional | 53 · Discontinued | $0.45 | $0.98 | $0.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.34 Median $0.72 Typical High $0.74 | Professional | 55 · Aftercare only | $0.34 | $0.72 | $0.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.48 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.23 | $0.48 | $0.49 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
Where Kansas sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 42nd of 51
$1.95
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.