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 $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $4.68 Typical High $4.68 | Professional | None | $3.24 | $4.68 | $4.68 |
BCBS Kansas Setting Facility Modifier None Typical Low $18.20 Median $19.05 Typical High $19.05 | Facility | None | $18.20 | $19.05 | $19.05 |
BCBS Kansas Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $5.25 Typical High $79.43 | Facility | None | $3.24 | $5.25 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.63 Median $4.17 Typical High $31.62 | Professional | None | $2.63 | $4.17 | $31.62 |
United Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Facility | None | $6.46 | $6.46 | $7.59 |
United Setting Professional Modifier None Typical Low $2.09 Median $3.09 Typical High $4.27 | Professional | None | $2.09 | $3.09 | $4.27 |
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 $1.62 Median $2.29 Typical High $2.34 | Professional | 52 · Reduced service | $1.62 | $2.29 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.93 Typical High $0.93 | Professional | 53 · Discontinued | $0.65 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.69 Typical High $0.71 | Professional | 55 · Aftercare only | $0.49 | $0.69 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.46 Typical High $0.47 | Professional | 56 · Pre-op care only | $0.33 | $0.46 | $0.47 |
Where Kansas sits
The same service costs 4.9 times more in Kansas 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· 1st of 51
$14.45
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.