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 $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $7.08 Typical High $7.08 | Professional | None | $3.31 | $7.08 | $7.08 |
BCBS Kansas Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Medica Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $10.96 | Facility | None | $4.47 | $4.47 | $10.96 |
Medica Setting Professional Modifier None Typical Low $2.29 Median $2.69 Typical High $83.18 | Professional | None | $2.29 | $2.69 | $83.18 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.69 Typical High $3.39 | Professional | None | $1.78 | $2.69 | $3.39 |
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 $1.66 Median $3.55 Typical High $3.55 | Professional | 52 · Reduced service | $1.66 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.66 Median $1.41 Typical High $1.41 | Professional | 53 · Discontinued | $0.66 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.45 Median $5.25 Typical High $5.37 | Professional | 54 · Surgery only | $2.45 | $5.25 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $1.05 Typical High $1.07 | Professional | 55 · Aftercare only | $0.49 | $1.05 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.71 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.33 | $0.71 | $0.71 |
Where Kansas sits
The same service costs 3.8 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· 29th of 51
$3.31
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.