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 $0.63 Median $0.72 Typical High $1.55 | Facility | None | $0.63 | $0.72 | $1.55 |
Aetna Setting Professional Modifier None Typical Low $0.54 Median $0.72 Typical High $1.55 | Professional | None | $0.54 | $0.72 | $1.55 |
BCBS Kansas Setting Facility Modifier None Typical Low $0.65 Median $0.68 Typical High $0.68 | Facility | None | $0.65 | $0.68 | $0.68 |
BCBS Kansas Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | None | $0.56 | $0.56 | $0.56 |
Cigna Setting Facility Modifier None Typical Low $0.55 Median $1.58 Typical High $2.09 | Facility | None | $0.55 | $1.58 | $2.09 |
Cigna Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Medica Setting Facility Modifier None Typical Low $0.68 Median $1.70 Typical High $1.70 | Facility | None | $0.68 | $1.70 | $1.70 |
Medica Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.98 | Professional | None | $0.56 | $0.56 | $0.98 |
United Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $1.35 | Professional | None | $0.54 | $0.54 | $1.35 |
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 $0.27 Median $0.37 Typical High $0.78 | Professional | 52 · Reduced service | $0.27 | $0.37 | $0.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.15 Typical High $0.31 | Professional | 53 · Discontinued | $0.11 | $0.15 | $0.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.11 Typical High $0.23 | Professional | 55 · Aftercare only | $0.08 | $0.11 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.07 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.05 | $0.07 | $0.16 |
Where Kansas sits
The same service costs 6.3 times more in Texas than in Mississippi. 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· 18th of 51
$0.65
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.