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 $0.79 Median $2.75 Typical High $2.75 | Facility | None | $0.79 | $2.75 | $2.75 |
Aetna Setting Professional Modifier None Typical Low $0.58 Median $0.79 Typical High $2.75 | Professional | None | $0.58 | $0.79 | $2.75 |
BCBS Kansas Setting Facility Modifier None Typical Low $0.72 Median $0.76 Typical High $0.76 | Facility | None | $0.72 | $0.76 | $0.76 |
BCBS Kansas Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | None | $0.58 | $0.58 | $0.58 |
Cigna Setting Facility Modifier None Typical Low $0.59 Median $2.00 Typical High $2.29 | Facility | None | $0.59 | $2.00 | $2.29 |
Cigna Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | None | $0.58 | $0.58 | $0.58 |
Medica Setting Facility Modifier None Typical Low $0.55 Median $2.63 Typical High $2.63 | Facility | None | $0.55 | $2.63 | $2.63 |
Medica Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $1.12 | Professional | None | $0.65 | $0.65 | $1.12 |
United Setting Facility Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Facility | None | $0.58 | $0.58 | $0.58 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $1.70 | Professional | None | $0.68 | $0.68 | $1.70 |
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 $0.28 Median $0.40 Typical High $1.38 | Professional | 52 · Reduced service | $0.28 | $0.40 | $1.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.16 Typical High $0.55 | Professional | 53 · Discontinued | $0.12 | $0.16 | $0.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $0.44 Median $0.59 Typical High $2.09 | Professional | 54 · Surgery only | $0.44 | $0.59 | $2.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.12 Typical High $0.42 | Professional | 55 · Aftercare only | $0.09 | $0.12 | $0.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.08 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.06 | $0.08 | $0.28 |
Where Kansas sits
The same service costs 4.1 times more in Wyoming than in Delaware. 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· 11th of 51
$0.72
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.