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 $1.00 Median $1.00 Typical High $1.70 | Facility | None | $1.00 | $1.00 | $1.70 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.41 Typical High $1.70 | Professional | None | $1.00 | $1.41 | $1.70 |
BCBS Kansas Setting Facility Modifier None Typical Low $1.29 Median $1.38 Typical High $1.38 | Facility | None | $1.29 | $1.38 | $1.38 |
BCBS Kansas Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Cigna Setting Facility Modifier None Typical Low $1.26 Median $3.63 Typical High $4.90 | Facility | None | $1.26 | $3.63 | $4.90 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Medica Setting Facility Modifier None Typical Low $1.00 Median $1.00 Typical High $1.32 | Facility | None | $1.00 | $1.00 | $1.32 |
Medica Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.74 | Professional | None | $1.12 | $1.12 | $1.74 |
United Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.74 | Professional | None | $1.38 | $1.38 | $1.74 |
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 $0.51 Median $0.71 Typical High $0.85 | Professional | 52 · Reduced service | $0.51 | $0.71 | $0.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.28 Typical High $0.34 | Professional | 53 · Discontinued | $0.20 | $0.28 | $0.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.21 Typical High $0.25 | Professional | 55 · Aftercare only | $0.15 | $0.21 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.14 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.10 | $0.14 | $0.17 |
Where Kansas sits
The same service costs 1.7 times more in Arizona 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· 41st of 51
$1.29
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.