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 $2.29 Median $2.29 Typical High $2.29 | Facility | None | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $1.07 Median $2.29 Typical High $2.29 | Professional | None | $1.07 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.54 Median $1.12 Typical High $1.15 | Professional | 52 · Reduced service | $0.54 | $1.12 | $1.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.46 Typical High $0.46 | Professional | 53 · Discontinued | $0.21 | $0.46 | $0.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.34 Typical High $0.35 | Professional | 55 · Aftercare only | $0.16 | $0.34 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.23 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.11 | $0.23 | $0.23 |
BCBS Kansas Setting Facility Modifier None Typical Low $1.35 Median $1.41 Typical High $1.41 | Facility | None | $1.35 | $1.41 | $1.41 |
BCBS Kansas Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Medica Setting Facility Modifier None Typical Low $1.35 Median $1.55 Typical High $1.95 | Facility | None | $1.35 | $1.55 | $1.95 |
Medica Setting Professional Modifier None Typical Low $0.76 Median $0.87 Typical High $8.71 | Professional | None | $0.76 | $0.87 | $8.71 |
United Setting Professional Modifier None Typical Low $0.59 Median $0.87 Typical High $1.12 | Professional | None | $0.59 | $0.87 | $1.12 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | A1 · Dressing, 1 wound | $1.26 | $1.26 | $1.26 |
Where Kansas sits
The same service costs 2.5 times more in Idaho 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
$1.35
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.