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 $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $15.14 Typical High $15.14 | Professional | None | $7.08 | $15.14 | $15.14 |
BCBS Kansas Setting Facility Modifier None Typical Low $9.12 Median $9.55 Typical High $9.55 | Facility | None | $9.12 | $9.55 | $9.55 |
BCBS Kansas Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | None | $6.46 | $6.46 | $7.59 |
Medica Setting Facility Modifier None Typical Low $6.17 Median $10.00 Typical High $79.43 | Facility | None | $6.17 | $10.00 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.80 Median $6.61 Typical High $57.54 | Professional | None | $3.80 | $6.61 | $57.54 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.75 Typical High $7.41 | Professional | None | $3.80 | $5.75 | $7.41 |
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 $3.55 Median $7.59 Typical High $7.59 | Professional | 52 · Reduced service | $3.55 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $3.02 Typical High $3.02 | Professional | 53 · Discontinued | $1.41 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.05 Median $2.24 Typical High $2.29 | Professional | 55 · Aftercare only | $1.05 | $2.24 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $1.51 Typical High $1.51 | Professional | 56 · Pre-op care only | $0.71 | $1.51 | $1.51 |
Where Kansas sits
The same service costs 2.1 times more in Idaho than in Connecticut. 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· 13th of 51
$9.55
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.