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 $3.98 Median $10.00 Typical High $10.00 | Facility | None | $3.98 | $10.00 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $4.79 Typical High $10.00 | Professional | None | $3.55 | $4.79 | $10.00 |
BCBS Kansas Setting Facility Modifier None Typical Low $5.50 Median $5.75 Typical High $5.75 | Facility | None | $5.50 | $5.75 | $5.75 |
BCBS Kansas Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $10.47 Typical High $13.80 | Facility | None | $3.63 | $10.47 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Medica Setting Facility Modifier None Typical Low $3.89 Median $13.80 Typical High $13.80 | Facility | None | $3.89 | $13.80 | $13.80 |
Medica Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $6.61 | Professional | None | $3.89 | $3.89 | $6.61 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $8.51 | Professional | None | $3.39 | $3.39 | $8.51 |
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 $1.78 Median $2.40 Typical High $5.01 | Professional | 52 · Reduced service | $1.78 | $2.40 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.98 Typical High $2.00 | Professional | 53 · Discontinued | $0.71 | $0.98 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.72 Typical High $1.51 | Professional | 55 · Aftercare only | $0.52 | $0.72 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.48 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.36 | $0.48 | $1.00 |
Where Kansas sits
The same service costs 4.0 times more in Oklahoma than in Maryland. 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
$5.50
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.