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 $2.88 Median $2.88 Typical High $3.55 | Facility | None | $2.88 | $2.88 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $3.55 Typical High $3.55 | Professional | None | $2.57 | $3.55 | $3.55 |
BCBS Kansas Setting Facility Modifier None Typical Low $2.75 Median $2.88 Typical High $2.88 | Facility | None | $2.75 | $2.88 | $2.88 |
BCBS Kansas Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Cigna Setting Facility Modifier None Typical Low $2.63 Median $7.59 Typical High $10.00 | Facility | None | $2.63 | $7.59 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Medica Setting Facility Modifier None Typical Low $2.24 Median $2.88 Typical High $2.88 | Facility | None | $2.24 | $2.88 | $2.88 |
Medica Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $3.16 | Professional | None | $2.40 | $2.40 | $3.16 |
United Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
United Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $3.31 | Professional | None | $2.45 | $2.45 | $3.31 |
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 $1.29 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $1.29 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.52 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.95 Median $2.63 Typical High $2.63 | Professional | 54 · Surgery only | $1.95 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.39 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.26 | $0.35 | $0.35 |
Where Kansas sits
The same service costs 1.8 times more in Alaska 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· 15th of 51
$2.75
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.