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 $2.04 Median $2.88 Typical High $3.31 | Facility | None | $2.04 | $2.88 | $3.31 |
Aetna Setting Professional Modifier None Typical Low $1.95 Median $2.63 Typical High $3.31 | Professional | None | $1.95 | $2.63 | $3.31 |
BCBS Kansas Setting Facility Modifier None Typical Low $3.55 Median $3.72 Typical High $3.72 | Facility | None | $3.55 | $3.72 | $3.72 |
BCBS Kansas Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Cigna Setting Facility Modifier None Typical Low $1.95 Median $5.62 Typical High $7.59 | Facility | None | $1.95 | $5.62 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
Medica Setting Facility Modifier None Typical Low $1.55 Median $2.88 Typical High $3.63 | Facility | None | $1.55 | $2.88 | $3.63 |
Medica Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $4.17 | Professional | None | $2.63 | $2.63 | $4.17 |
United Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $4.79 | Professional | None | $1.95 | $1.95 | $4.79 |
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 $0.98 Median $1.32 Typical High $1.66 | Professional | 52 · Reduced service | $0.98 | $1.32 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.52 Typical High $0.66 | Professional | 53 · Discontinued | $0.39 | $0.52 | $0.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.39 Typical High $0.50 | Professional | 55 · Aftercare only | $0.28 | $0.39 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.26 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.19 | $0.26 | $0.33 |
Where Kansas sits
The same service costs 2.5 times more in Texas than in Tennessee. 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
$3.31
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.