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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $100.00 | Professional | None | $63.10 | $91.20 | $100.00 |
BCBS Kansas Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $100.00 | Facility | None | $95.50 | $100.00 | $100.00 |
BCBS Kansas Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $89.13 Typical High $537.03 | Facility | None | $63.10 | $89.13 | $537.03 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $66.07 Typical High $588.84 | Professional | None | $40.74 | $66.07 | $588.84 |
United Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $141.25 | Facility | None | $57.54 | $63.10 | $141.25 |
United Setting Professional Modifier None Typical Low $38.02 Median $57.54 Typical High $77.62 | Professional | None | $38.02 | $57.54 | $77.62 |
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 $31.62 Median $45.71 Typical High $50.12 | Professional | 52 · Reduced service | $31.62 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $18.20 Typical High $19.95 | Professional | 53 · Discontinued | $12.59 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $13.80 Typical High $14.79 | Professional | 55 · Aftercare only | $9.55 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $9.12 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.31 | $9.12 | $10.00 |
Where Kansas sits
The same service costs 2.4 times more in Montana 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· 9th of 51
$100
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.