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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $42.66 Typical High $43.65 | Professional | None | $20.42 | $42.66 | $43.65 |
BCBS Kansas Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Medica Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $67.61 | Facility | None | $27.54 | $27.54 | $67.61 |
Medica Setting Professional Modifier None Typical Low $14.13 Median $16.60 Typical High $338.84 | Professional | None | $14.13 | $16.60 | $338.84 |
United Setting Professional Modifier None Typical Low $10.96 Median $16.60 Typical High $20.89 | Professional | None | $10.96 | $16.60 | $20.89 |
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 $10.00 Median $21.38 Typical High $21.88 | Professional | 52 · Reduced service | $10.00 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $4.07 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.14 Median $32.36 Typical High $33.11 | Professional | 54 · Surgery only | $15.14 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $6.46 Typical High $6.61 | Professional | 55 · Aftercare only | $3.02 | $6.46 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $4.27 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.04 | $4.27 | $4.37 |
Where Kansas sits
The same service costs 2.6 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
$20.42
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.