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 $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $8.13 Typical High $8.32 | Professional | None | $5.75 | $8.13 | $8.32 |
BCBS Kansas Setting Facility Modifier None Typical Low $2.95 Median $3.09 Typical High $3.16 | Facility | None | $2.95 | $3.09 | $3.16 |
BCBS Kansas Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
Medica Setting Facility Modifier None Typical Low $5.75 Median $9.33 Typical High $79.43 | Facility | None | $5.75 | $9.33 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.68 Median $7.41 Typical High $74.13 | Professional | None | $4.68 | $7.41 | $74.13 |
United Setting Facility Modifier None Typical Low $6.31 Median $7.94 Typical High $15.14 | Facility | None | $6.31 | $7.94 | $15.14 |
United Setting Professional Modifier None Typical Low $3.72 Median $5.50 Typical High $8.51 | Professional | None | $3.72 | $5.50 | $8.51 |
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 $2.88 Median $4.07 Typical High $4.17 | Professional | 52 · Reduced service | $2.88 | $4.07 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.62 Typical High $1.66 | Professional | 53 · Discontinued | $1.15 | $1.62 | $1.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $1.23 Typical High $1.23 | Professional | 55 · Aftercare only | $0.85 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.81 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.58 | $0.81 | $0.83 |
Where Kansas sits
The same service costs 3.5 times more in Montana than in Kansas. 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· 51st of 51
$4.37
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.