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 $3.55 Median $3.55 Typical High $4.37 | Facility | None | $3.55 | $3.55 | $4.37 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.63 Typical High $4.37 | Professional | None | $3.24 | $3.63 | $4.37 |
BCBS Kansas Setting Facility Modifier None Typical Low $3.80 Median $3.98 Typical High $3.98 | Facility | None | $3.80 | $3.98 | $3.98 |
BCBS Kansas Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $3.31 Median $10.96 Typical High $12.59 | Facility | None | $3.31 | $10.96 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $3.55 Typical High $3.80 | Facility | None | $3.24 | $3.55 | $3.80 |
Medica Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.90 | Professional | None | $3.24 | $3.24 | $4.90 |
United Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.55 | Professional | None | $3.24 | $3.24 | $3.55 |
5 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 $1.62 Median $1.82 Typical High $2.19 | Professional | 52 · Reduced service | $1.62 | $1.82 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.72 Typical High $0.87 | Professional | 53 · Discontinued | $0.65 | $0.72 | $0.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.45 Median $2.69 Typical High $3.31 | Professional | 54 · Surgery only | $2.45 | $2.69 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.54 Typical High $0.66 | Professional | 55 · Aftercare only | $0.49 | $0.54 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.36 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.32 | $0.36 | $0.44 |
Where Kansas sits
The same service costs 1.7 times more in Arizona than in North Dakota. 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· 7th of 51
$3.80
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.