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 $9.55 Median $12.02 Typical High $12.02 | Facility | None | $9.55 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $12.02 Typical High $12.02 | Professional | None | $9.55 | $12.02 | $12.02 |
BCBS Kansas Setting Facility Modifier None Typical Low $14.45 Median $15.14 Typical High $15.14 | Facility | None | $14.45 | $15.14 | $15.14 |
BCBS Kansas Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $10.47 Median $11.75 Typical High $18.62 | Facility | None | $10.47 | $11.75 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
Medica Setting Facility Modifier None Typical Low $12.88 Median $20.89 Typical High $33.11 | Facility | None | $12.88 | $20.89 | $33.11 |
Medica Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $19.95 | Professional | None | $10.72 | $10.72 | $19.95 |
United Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $18.20 | Professional | None | $10.00 | $10.00 | $18.20 |
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 $4.79 Median $6.03 Typical High $6.03 | Professional | 52 · Reduced service | $4.79 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $2.40 Typical High $2.40 | Professional | 53 · Discontinued | $1.91 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.45 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.20 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.95 | $1.20 | $1.20 |
Where Kansas sits
The same service costs 9.1 times more in Alabama 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· 14th of 51
$14.45
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.