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 $0.37 Median $0.37 Typical High $0.42 | Facility | None | $0.37 | $0.37 | $0.42 |
Aetna Setting Professional Modifier None Typical Low $0.31 Median $0.42 Typical High $0.42 | Professional | None | $0.31 | $0.42 | $0.42 |
BCBS Kansas Setting Facility Modifier None Typical Low $0.52 Median $0.55 Typical High $0.55 | Facility | None | $0.52 | $0.55 | $0.55 |
BCBS Kansas Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Cigna Setting Facility Modifier None Typical Low $0.39 Median $1.10 Typical High $1.23 | Facility | None | $0.39 | $1.10 | $1.23 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Medica Setting Facility Modifier None Typical Low $0.48 Median $0.65 Typical High $0.65 | Facility | None | $0.48 | $0.65 | $0.65 |
Medica Setting Professional Modifier None Typical Low $0.41 Median $0.43 Typical High $0.65 | Professional | None | $0.41 | $0.43 | $0.65 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.62 | Professional | None | $0.32 | $0.32 | $0.62 |
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 $0.16 Median $0.21 Typical High $0.21 | Professional | 52 · Reduced service | $0.16 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.06 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.05 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.04 |
Where Kansas sits
The same service costs 3.3 times more in Texas than in North Dakota. 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· 6th of 51
$0.52
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.