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 $5.25 Median $5.25 Typical High $6.31 | Facility | None | $5.25 | $5.25 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $6.31 Typical High $6.31 | Professional | None | $4.68 | $6.31 | $6.31 |
BCBS Kansas Setting Facility Modifier None Typical Low $5.13 Median $5.37 Typical High $5.37 | Facility | None | $5.13 | $5.37 | $5.37 |
BCBS Kansas Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $13.49 Typical High $18.20 | Facility | None | $4.79 | $13.49 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Medica Setting Facility Modifier None Typical Low $4.47 Median $5.62 Typical High $5.62 | Facility | None | $4.47 | $5.62 | $5.62 |
Medica Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $6.03 | Professional | None | $4.57 | $4.57 | $6.03 |
United Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
United Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $6.31 | Professional | None | $4.47 | $4.47 | $6.31 |
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 $2.34 Median $3.16 Typical High $3.16 | Professional | 52 · Reduced service | $2.34 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $1.26 Typical High $1.26 | Professional | 53 · Discontinued | $0.93 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $0.95 Typical High $0.95 | Professional | 55 · Aftercare only | $0.71 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.65 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.47 | $0.65 | $0.65 |
Where Kansas sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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· 12th of 51
$5.13
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.