How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $57.54 Typical High $57.54 | Professional | None | $26.92 | $57.54 | $57.54 |
BCBS Kansas Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $89.13 | Facility | None | $36.31 | $36.31 | $89.13 |
Medica Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $398.11 | Professional | None | $18.62 | $21.88 | $398.11 |
United Setting Professional Modifier None Typical Low $14.45 Median $21.88 Typical High $27.54 | Professional | None | $14.45 | $21.88 | $27.54 |
5 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 $13.49 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $13.49 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $5.37 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $42.66 Typical High $43.65 | Professional | 54 · Surgery only | $19.95 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $8.51 Typical High $8.71 | Professional | 55 · Aftercare only | $3.98 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.69 | $5.75 | $5.75 |
Where Kansas sits
The same service costs 2.7 times more in Hawaii than in New York. 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· 29th of 51
$26.92
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.