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 $0.46 Median $0.63 Typical High $1.51 | Facility | None | $0.46 | $0.63 | $1.51 |
Aetna Setting Professional Modifier None Typical Low $0.37 Median $0.50 Typical High $1.51 | Professional | None | $0.37 | $0.50 | $1.51 |
BCBS Kansas Setting Facility Modifier None Typical Low $0.40 Median $0.42 Typical High $0.42 | Facility | None | $0.40 | $0.42 | $0.42 |
BCBS Kansas Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | None | $0.38 | $0.38 | $0.38 |
Cigna Setting Facility Modifier None Typical Low $0.38 Median $1.07 Typical High $1.45 | Facility | None | $0.38 | $1.07 | $1.45 |
Cigna Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | None | $0.37 | $0.37 | $0.37 |
Medica Setting Facility Modifier None Typical Low $0.31 Median $1.86 Typical High $1.86 | Facility | None | $0.31 | $1.86 | $1.86 |
Medica Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.52 | Professional | None | $0.31 | $0.31 | $0.52 |
United Setting Facility Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Facility | None | $0.37 | $0.37 | $0.37 |
United Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.58 | Professional | None | $0.23 | $0.23 | $0.58 |
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 $0.19 Median $0.25 Typical High $0.76 | Professional | 52 · Reduced service | $0.19 | $0.25 | $0.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.10 Typical High $0.30 | Professional | 53 · Discontinued | $0.07 | $0.10 | $0.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.08 Typical High $0.23 | Professional | 55 · Aftercare only | $0.06 | $0.08 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.05 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.04 | $0.05 | $0.15 |
Where Kansas sits
The same service costs 7.8 times more in Texas than in Maryland. 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· 15th of 51
$0.40
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.