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 $3.39 Median $3.89 Typical High $5.75 | Facility | None | $3.39 | $3.89 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $3.89 Typical High $5.75 | Professional | None | $2.82 | $3.89 | $5.75 |
BCBS Kansas Setting Facility Modifier None Typical Low $4.47 Median $4.68 Typical High $4.68 | Facility | None | $4.47 | $4.68 | $4.68 |
BCBS Kansas Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $8.32 Typical High $11.22 | Facility | None | $2.88 | $8.32 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Medica Setting Facility Modifier None Typical Low $3.09 Median $5.37 Typical High $5.37 | Facility | None | $3.09 | $5.37 | $5.37 |
Medica Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $5.13 | Professional | None | $3.02 | $3.02 | $5.13 |
United Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $5.25 | Professional | None | $3.09 | $3.09 | $5.25 |
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 $1.45 Median $1.95 Typical High $2.88 | Professional | 52 · Reduced service | $1.45 | $1.95 | $2.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.78 Typical High $1.15 | Professional | 53 · Discontinued | $0.56 | $0.78 | $1.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.58 Typical High $0.87 | Professional | 55 · Aftercare only | $0.43 | $0.58 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.39 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.28 | $0.39 | $0.58 |
Where Kansas sits
The same service costs 2.0 times more in Wyoming than in Florida. 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
$4.47
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.