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 $4.07 Median $4.17 Typical High $4.79 | Facility | None | $4.07 | $4.17 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $4.17 Typical High $4.79 | Professional | None | $3.55 | $4.17 | $4.79 |
BCBS Kansas Setting Facility Modifier None Typical Low $4.68 Median $4.90 Typical High $4.90 | Facility | None | $4.68 | $4.90 | $4.90 |
BCBS Kansas Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $10.23 Typical High $13.80 | Facility | None | $3.55 | $10.23 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Medica Setting Facility Modifier None Typical Low $3.55 Median $4.17 Typical High $4.17 | Facility | None | $3.55 | $4.17 | $4.17 |
Medica Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.07 | Professional | None | $3.55 | $3.55 | $4.07 |
United Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.98 | Professional | None | $3.55 | $3.55 | $3.98 |
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 $1.78 Median $2.09 Typical High $2.40 | Professional | 52 · Reduced service | $1.78 | $2.09 | $2.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.83 Typical High $0.95 | Professional | 53 · Discontinued | $0.71 | $0.83 | $0.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.62 Typical High $0.72 | Professional | 55 · Aftercare only | $0.52 | $0.62 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.42 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.35 | $0.42 | $0.48 |
Where Kansas sits
The same service costs 1.7 times more in Arizona than in Illinois. 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· 3rd of 51
$4.68
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.