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 $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $1.48 Median $3.16 Typical High $3.24 | Professional | None | $1.48 | $3.16 | $3.24 |
Ambetter Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
BCBS Kansas Setting Facility Modifier None Typical Low $1.86 Median $1.95 Typical High $1.95 | Facility | None | $1.86 | $1.95 | $1.95 |
BCBS Kansas Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.12 | Professional | None | $1.02 | $1.02 | $1.12 |
Medica Setting Facility Modifier None Typical Low $1.95 Median $7.08 Typical High $7.08 | Facility | None | $1.95 | $7.08 | $7.08 |
Medica Setting Professional Modifier None Typical Low $1.05 Median $1.23 Typical High $12.30 | Professional | None | $1.05 | $1.23 | $12.30 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.23 Typical High $1.66 | Professional | None | $0.81 | $1.23 | $1.66 |
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 $0.76 Median $1.58 Typical High $1.62 | Professional | 52 · Reduced service | $0.76 | $1.58 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.30 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.48 Typical High $0.48 | Professional | 55 · Aftercare only | $0.22 | $0.48 | $0.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.32 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.15 | $0.32 | $0.32 |
Where Kansas sits
The same service costs 4.6 times more in Rhode Island 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· 22nd of 51
$1.78
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.