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 $2.09 Median $2.09 Typical High $2.63 | Facility | None | $2.09 | $2.09 | $2.63 |
Aetna Setting Professional Modifier None Typical Low $2.09 Median $2.63 Typical High $2.63 | Professional | None | $2.09 | $2.63 | $2.63 |
BCBS Setting Facility Modifier None Typical Low $8.71 Median $9.12 Typical High $9.12 | Facility | None | $8.71 | $9.12 | $9.12 |
BCBS 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 $2.29 Median $2.57 Typical High $4.07 | Facility | None | $2.29 | $2.57 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Medica Setting Facility Modifier None Typical Low $2.09 Median $2.63 Typical High $100.00 | Facility | None | $2.09 | $2.63 | $100.00 |
Medica Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.63 | Professional | None | $2.24 | $2.24 | $2.63 |
United Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.57 | Professional | None | $2.24 | $2.24 | $2.57 |
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 $1.07 Median $1.32 Typical High $1.32 | Professional | 52 · Reduced service | $1.07 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.52 Typical High $0.52 | Professional | 53 · Discontinued | $0.42 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.40 Typical High $0.40 | Professional | 55 · Aftercare only | $0.32 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.26 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.21 | $0.26 | $0.26 |
Where Kansas sits
The same service costs 128.8 times more in Kansas than in New York. 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.