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 $5.01 Median $5.01 Typical High $5.01 | Facility | None | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $4.90 Typical High $5.01 | Professional | None | $2.29 | $4.90 | $5.01 |
BCBS Kansas Setting Facility Modifier None Typical Low $3.89 Median $4.07 Typical High $4.07 | Facility | None | $3.89 | $4.07 | $4.07 |
BCBS Kansas Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $2.82 | Facility | None | $2.69 | $2.69 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.69 | Professional | None | $2.29 | $2.29 | $2.69 |
Medica Setting Facility Modifier None Typical Low $2.04 Median $3.31 Typical High $79.43 | Facility | None | $2.04 | $3.31 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.32 Median $2.19 Typical High $21.38 | Professional | None | $1.32 | $2.19 | $21.38 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.91 Typical High $2.69 | Professional | None | $1.26 | $1.91 | $2.69 |
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 $1.15 Median $2.45 Typical High $2.51 | Professional | 52 · Reduced service | $1.15 | $2.45 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.98 Typical High $1.00 | Professional | 53 · Discontinued | $0.46 | $0.98 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.74 Typical High $0.76 | Professional | 55 · Aftercare only | $0.35 | $0.74 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.49 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.23 | $0.49 | $0.50 |
Where Kansas sits
The same service costs 2.1 times more in Montana 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· 5th of 51
$3.98
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.