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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $47.86 Typical High $47.86 | Professional | None | $22.39 | $47.86 | $47.86 |
BCBS Kansas Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $74.13 | Facility | None | $30.20 | $30.20 | $74.13 |
Medica Setting Professional Modifier None Typical Low $15.49 Median $18.20 Typical High $457.09 | Professional | None | $15.49 | $18.20 | $457.09 |
United Setting Professional Modifier None Typical Low $12.02 Median $18.20 Typical High $22.91 | Professional | None | $12.02 | $18.20 | $22.91 |
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 $11.22 Median $23.44 Typical High $23.99 | Professional | 52 · Reduced service | $11.22 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $4.47 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.60 Median $35.48 Typical High $36.31 | Professional | 54 · Surgery only | $16.60 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $7.08 Typical High $7.24 | Professional | 55 · Aftercare only | $3.31 | $7.08 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.24 | $4.79 | $4.79 |
Where Kansas sits
The same service costs 3.1 times more in Rhode Island 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· 32nd of 51
$22.39
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.