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 $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $6.46 Typical High $6.46 | Professional | None | $3.02 | $6.46 | $6.46 |
BCBS Kansas Setting Facility Modifier None Typical Low $4.90 Median $5.13 Typical High $5.13 | Facility | None | $4.90 | $5.13 | $5.13 |
BCBS Kansas Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Facility | None | $2.95 | $2.95 | $2.95 |
Cigna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.95 | Professional | None | $2.51 | $2.51 | $2.95 |
Medica Setting Facility Modifier None Typical Low $2.63 Median $4.27 Typical High $79.43 | Facility | None | $2.63 | $4.27 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.62 Median $2.82 Typical High $24.55 | Professional | None | $1.62 | $2.82 | $24.55 |
United Setting Professional Modifier None Typical Low $1.62 Median $2.45 Typical High $3.16 | Professional | None | $1.62 | $2.45 | $3.16 |
2 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 55 · Aftercare only Typical Low $0.45 Median $0.95 Typical High $0.98 | Professional | 55 · Aftercare only | $0.45 | $0.95 | $0.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.65 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.30 | $0.65 | $0.65 |
Where Kansas sits
The same service costs 2.1 times more in Montana than in Colorado. 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· 4th of 51
$5.01
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.