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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $25.70 Typical High $25.70 | Professional | None | $12.02 | $25.70 | $25.70 |
BCBS Kansas Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Medica Setting Facility Modifier None Typical Low $15.85 Median $16.22 Typical High $39.81 | Facility | None | $15.85 | $16.22 | $39.81 |
Medica Setting Professional Modifier None Typical Low $8.32 Median $9.77 Typical High $158.49 | Professional | None | $8.32 | $9.77 | $158.49 |
United Setting Professional Modifier None Typical Low $6.61 Median $9.77 Typical High $12.30 | Professional | None | $6.61 | $9.77 | $12.30 |
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 $6.03 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $6.03 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $5.13 Typical High $5.25 | Professional | 53 · Discontinued | $2.40 | $5.13 | $5.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $19.05 Typical High $19.50 | Professional | 54 · Surgery only | $8.91 | $19.05 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $3.80 Typical High $3.89 | Professional | 55 · Aftercare only | $1.82 | $3.80 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.20 | $2.57 | $2.57 |
Where Kansas sits
The same service costs 2.8 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· 30th of 51
$12.02
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.