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 $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $11.75 Typical High $12.02 | Professional | None | $5.62 | $11.75 | $12.02 |
BCBS Kansas Setting Facility Modifier None Typical Low $10.47 Median $10.96 Typical High $10.96 | Facility | None | $10.47 | $10.96 | $10.96 |
BCBS Kansas Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | None | $4.68 | $4.68 | $5.50 |
Medica Setting Facility Modifier None Typical Low $4.90 Median $7.94 Typical High $79.43 | Facility | None | $4.90 | $7.94 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.02 Median $5.25 Typical High $45.71 | Professional | None | $3.02 | $5.25 | $45.71 |
United Setting Professional Modifier None Typical Low $2.95 Median $4.57 Typical High $5.75 | Professional | None | $2.95 | $4.57 | $5.75 |
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 $2.75 Median $5.89 Typical High $6.03 | Professional | 52 · Reduced service | $2.75 | $5.89 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $2.34 Typical High $2.40 | Professional | 53 · Discontinued | $1.12 | $2.34 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $1.78 Typical High $1.82 | Professional | 55 · Aftercare only | $0.83 | $1.78 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $1.17 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.56 | $1.17 | $1.20 |
Where Kansas sits
The same service costs 2.3 times more in Kansas than in Alabama. 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
$10.72
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.