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 $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $3.39 Typical High $3.39 | Professional | None | $1.58 | $3.39 | $3.39 |
BCBS Kansas Setting Facility Modifier None Typical Low $2.95 Median $3.09 Typical High $3.09 | Facility | None | $2.95 | $3.09 | $3.09 |
BCBS Kansas Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.55 | Facility | None | $1.55 | $1.55 | $1.55 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.55 | Professional | None | $1.32 | $1.32 | $1.55 |
Medica Setting Facility Modifier None Typical Low $1.38 Median $2.24 Typical High $79.43 | Facility | None | $1.38 | $2.24 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.85 Median $1.48 Typical High $12.88 | Professional | None | $0.85 | $1.48 | $12.88 |
United Setting Professional Modifier None Typical Low $0.85 Median $1.29 Typical High $1.66 | Professional | None | $0.85 | $1.29 | $1.66 |
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 $0.79 Median $1.70 Typical High $1.70 | Professional | 52 · Reduced service | $0.79 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.68 Typical High $0.68 | Professional | 53 · Discontinued | $0.32 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.51 Typical High $0.51 | Professional | 55 · Aftercare only | $0.24 | $0.51 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.16 | $0.34 | $0.34 |
Where Kansas sits
The same service costs 2.3 times more in Kansas than in New Jersey. 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· 1st of 51
$3.09
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.