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 $0.74 Median $0.74 Typical High $0.91 | Facility | None | $0.74 | $0.74 | $0.91 |
Aetna Setting Professional Modifier None Typical Low $0.74 Median $0.91 Typical High $0.91 | Professional | None | $0.74 | $0.91 | $0.91 |
BCBS Kansas Setting Facility Modifier None Typical Low $8.71 Median $9.12 Typical High $9.12 | Facility | None | $8.71 | $9.12 | $9.12 |
BCBS Kansas Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Cigna Setting Facility Modifier None Typical Low $0.81 Median $0.91 Typical High $1.45 | Facility | None | $0.81 | $0.91 | $1.45 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Medica Setting Facility Modifier None Typical Low $0.28 Median $0.91 Typical High $1.10 | Facility | None | $0.28 | $0.91 | $1.10 |
Medica Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.87 | Professional | None | $0.79 | $0.79 | $0.87 |
United Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.87 | Professional | None | $0.79 | $0.79 | $0.87 |
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 $0.37 Median $0.46 Typical High $0.46 | Professional | 52 · Reduced service | $0.37 | $0.46 | $0.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.18 Typical High $0.18 | Professional | 53 · Discontinued | $0.15 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.11 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.07 | $0.09 | $0.09 |
Where Kansas sits
The same service costs 14.5 times more in Kansas than in Montana. 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
$7.76
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.