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 $0.15 Median $0.17 Typical High $0.40 | Facility | None | $0.15 | $0.17 | $0.40 |
Aetna Setting Professional Modifier None Typical Low $0.14 Median $0.18 Typical High $0.40 | Professional | None | $0.14 | $0.18 | $0.40 |
BCBS Kansas Setting Facility Modifier None Typical Low $0.25 Median $0.26 Typical High $0.26 | Facility | None | $0.25 | $0.26 | $0.26 |
BCBS Kansas Setting Professional Modifier None Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | None | $0.14 | $0.14 | $0.14 |
Cigna Setting Facility Modifier None Typical Low $0.14 Median $0.40 Typical High $0.54 | Facility | None | $0.14 | $0.40 | $0.54 |
Cigna Setting Professional Modifier None Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | None | $0.14 | $0.14 | $0.14 |
Medica Setting Facility Modifier None Typical Low $0.11 Median $0.39 Typical High $0.39 | Facility | None | $0.11 | $0.39 | $0.39 |
Medica Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $0.28 | Professional | None | $0.17 | $0.17 | $0.28 |
United Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.33 | Professional | None | $0.13 | $0.13 | $0.33 |
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 $0.07 Median $0.09 Typical High $0.20 | Professional | 52 · Reduced service | $0.07 | $0.09 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.04 Typical High $0.08 | Professional | 53 · Discontinued | $0.03 | $0.04 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.03 Typical High $0.06 | Professional | 55 · Aftercare only | $0.02 | $0.03 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.04 |
Where Kansas sits
The same service costs 4.7 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
$0.25
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.