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 $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $3.72 Typical High $3.80 | Professional | None | $1.58 | $3.72 | $3.80 |
BCBS Kansas Setting Facility Modifier None Typical Low $3.89 Median $4.07 Typical High $4.17 | Facility | None | $3.89 | $4.07 | $4.17 |
BCBS Kansas Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.82 | Facility | None | $1.74 | $1.74 | $1.82 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.74 | Professional | None | $1.48 | $1.48 | $1.74 |
Medica Setting Facility Modifier None Typical Low $1.51 Median $2.51 Typical High $79.43 | Facility | None | $1.51 | $2.51 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.95 Median $1.66 Typical High $14.45 | Professional | None | $0.95 | $1.66 | $14.45 |
United Setting Professional Modifier None Typical Low $0.85 Median $1.45 Typical High $1.82 | Professional | None | $0.85 | $1.45 | $1.82 |
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 $0.87 Median $1.86 Typical High $1.91 | Professional | 52 · Reduced service | $0.87 | $1.86 | $1.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.76 Typical High $0.76 | Professional | 53 · Discontinued | $0.35 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.26 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.37 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.18 | $0.37 | $0.38 |
Where Kansas sits
The same service costs 2.2 times more in Kansas than in Alabama. 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· 1st of 51
$3.31
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.