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 $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $4.90 Median $10.47 Typical High $10.72 | Professional | None | $4.90 | $10.47 | $10.72 |
BCBS Kansas Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Medica Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $16.60 | Facility | None | $6.76 | $6.76 | $16.60 |
Medica Setting Professional Modifier None Typical Low $3.47 Median $4.07 Typical High $107.15 | Professional | None | $3.47 | $4.07 | $107.15 |
United Setting Professional Modifier None Typical Low $2.69 Median $4.07 Typical High $5.13 | Professional | None | $2.69 | $4.07 | $5.13 |
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 $2.45 Median $5.25 Typical High $5.37 | Professional | 52 · Reduced service | $2.45 | $5.25 | $5.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $2.09 Typical High $2.14 | Professional | 53 · Discontinued | $1.00 | $2.09 | $2.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.72 Median $7.94 Typical High $7.94 | Professional | 54 · Surgery only | $3.72 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.74 Median $1.58 Typical High $1.58 | Professional | 55 · Aftercare only | $0.74 | $1.58 | $1.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $1.05 Typical High $1.07 | Professional | 56 · Pre-op care only | $0.49 | $1.05 | $1.07 |
Where Kansas sits
The same service costs 3.2 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· 30th of 51
$4.90
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.