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 $0.37 Median $0.46 Typical High $0.46 | Facility | None | $0.37 | $0.46 | $0.46 |
Aetna Setting Professional Modifier None Typical Low $0.37 Median $0.46 Typical High $0.46 | Professional | None | $0.37 | $0.46 | $0.46 |
BCBS Kansas Setting Facility Modifier None Typical Low $2.14 Median $2.29 Typical High $2.29 | Facility | None | $2.14 | $2.29 | $2.29 |
BCBS Kansas Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Cigna Setting Facility Modifier None Typical Low $0.27 Median $0.31 Typical High $0.49 | Facility | None | $0.27 | $0.31 | $0.49 |
Cigna Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | None | $0.27 | $0.27 | $0.27 |
Medica Setting Facility Modifier None Typical Low $0.32 Median $0.81 Typical High $0.81 | Facility | None | $0.32 | $0.81 | $0.81 |
Medica Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.68 | Professional | None | $0.27 | $0.27 | $0.68 |
United Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.95 | Professional | None | $0.38 | $0.38 | $0.95 |
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 $0.19 Median $0.23 Typical High $0.23 | Professional | 52 · Reduced service | $0.19 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.07 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.06 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.05 | $0.05 |
Where Kansas sits
The same service costs 6.3 times more in Kansas than in Virginia. 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
$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.