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 $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
Aetna Setting Professional Modifier None Typical Low $0.58 Median $1.23 Typical High $1.26 | Professional | None | $0.58 | $1.23 | $1.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.28 Median $0.62 Typical High $0.63 | Professional | 52 · Reduced service | $0.28 | $0.62 | $0.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.25 Typical High $0.25 | Professional | 53 · Discontinued | $0.12 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.12 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.06 | $0.12 | $0.13 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
BCBS Kansas Setting Facility Modifier None Typical Low $0.72 Median $0.76 Typical High $0.76 | Facility | None | $0.72 | $0.76 | $0.76 |
BCBS Kansas Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Medica Setting Facility Modifier None Typical Low $0.71 Median $0.81 Typical High $1.07 | Facility | None | $0.71 | $0.81 | $1.07 |
Medica Setting Professional Modifier None Typical Low $0.41 Median $0.48 Typical High $4.68 | Professional | None | $0.41 | $0.48 | $4.68 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.48 Typical High $0.62 | Professional | None | $0.32 | $0.48 | $0.62 |
1 more rate 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 $0.09 Median $0.19 Typical High $0.19 | Professional | 55 · Aftercare only | $0.09 | $0.19 | $0.19 |
Where Kansas sits
The same service costs 2.6 times more in Hawaii 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· 18th of 51
$0.72
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.