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 $1.02 Median $1.02 Typical High $1.02 | Facility | None | $1.02 | $1.02 | $1.02 |
Aetna Setting Professional Modifier None Typical Low $0.48 Median $1.00 Typical High $1.02 | Professional | None | $0.48 | $1.00 | $1.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.24 Median $0.51 Typical High $0.52 | Professional | 52 · Reduced service | $0.24 | $0.51 | $0.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.20 Typical High $0.21 | Professional | 53 · Discontinued | $0.10 | $0.20 | $0.21 |
BCBS Kansas Setting Facility Modifier None Typical Low $0.60 Median $0.63 Typical High $0.63 | Facility | None | $0.60 | $0.63 | $0.63 |
BCBS Kansas Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | None | $0.62 | $0.62 | $0.62 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Medica Setting Facility Modifier None Typical Low $0.59 Median $0.68 Typical High $0.85 | Facility | None | $0.59 | $0.68 | $0.85 |
Medica Setting Professional Modifier None Typical Low $0.33 Median $0.39 Typical High $3.89 | Professional | None | $0.33 | $0.39 | $3.89 |
United Setting Professional Modifier None Typical Low $0.26 Median $0.39 Typical High $0.50 | Professional | None | $0.26 | $0.39 | $0.50 |
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 $0.07 Median $0.15 Typical High $0.15 | Professional | 55 · Aftercare only | $0.07 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.05 | $0.10 | $0.10 |
Where Kansas sits
The same service costs 2.6 times more in Hawaii than in Utah. 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
$0.60
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.