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 $3.89 Median $4.37 Typical High $4.90 | Facility | None | $3.89 | $4.37 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $4.07 Typical High $4.90 | Professional | None | $3.63 | $4.07 | $4.90 |
BCBS Kansas Setting Facility Modifier None Typical Low $4.07 Median $4.27 Typical High $4.27 | Facility | None | $4.07 | $4.27 | $4.27 |
BCBS Kansas Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Cigna Setting Facility Modifier None Typical Low $3.72 Median $10.72 Typical High $14.13 | Facility | None | $3.72 | $10.72 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
Medica Setting Facility Modifier None Typical Low $2.04 Median $3.89 Typical High $3.98 | Facility | None | $2.04 | $3.89 | $3.98 |
Medica Setting Professional Modifier None Typical Low $2.88 Median $3.02 Typical High $4.90 | Professional | None | $2.88 | $3.02 | $4.90 |
United Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $5.37 | Professional | None | $3.31 | $3.31 | $5.37 |
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 $1.82 Median $2.04 Typical High $2.45 | Professional | 52 · Reduced service | $1.82 | $2.04 | $2.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.81 Typical High $1.00 | Professional | 53 · Discontinued | $0.72 | $0.81 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.55 Median $0.62 Typical High $0.74 | Professional | 55 · Aftercare only | $0.55 | $0.62 | $0.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.41 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.36 | $0.41 | $0.50 |
Where Kansas sits
The same service costs 2.5 times more in Alaska than in Oklahoma. 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· 5th of 51
$4.07
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.