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 $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $5.89 Typical High $6.03 | Professional | None | $4.17 | $5.89 | $6.03 |
BCBS Kansas Setting Facility Modifier None Typical Low $6.17 Median $6.46 Typical High $6.46 | Facility | None | $6.17 | $6.46 | $6.46 |
BCBS Kansas Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $5.13 | Professional | None | $3.80 | $3.80 | $5.13 |
Medica Setting Facility Modifier None Typical Low $4.17 Median $6.76 Typical High $79.43 | Facility | None | $4.17 | $6.76 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.39 Median $5.37 Typical High $53.70 | Professional | None | $3.39 | $5.37 | $53.70 |
United Setting Facility Modifier None Typical Low $4.79 Median $5.37 Typical High $10.96 | Facility | None | $4.79 | $5.37 | $10.96 |
United Setting Professional Modifier None Typical Low $2.63 Median $3.98 Typical High $6.17 | Professional | None | $2.63 | $3.98 | $6.17 |
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 $2.09 Median $2.95 Typical High $3.02 | Professional | 52 · Reduced service | $2.09 | $2.95 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $1.20 Typical High $1.20 | Professional | 53 · Discontinued | $0.83 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.89 Typical High $0.89 | Professional | 55 · Aftercare only | $0.63 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.59 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.42 | $0.59 | $0.60 |
Where Kansas sits
The same service costs 3.2 times more in Hawaii 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· 16th of 51
$6.46
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.