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 $6.03 Median $6.03 Typical High $7.59 | Facility | None | $6.03 | $6.03 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $7.41 Typical High $7.59 | Professional | None | $3.47 | $7.41 | $7.59 |
BCBS Kansas Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
Medica Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $11.48 | Facility | None | $4.68 | $4.68 | $11.48 |
Medica Setting Professional Modifier None Typical Low $2.40 Median $2.82 Typical High $69.18 | Professional | None | $2.40 | $2.82 | $69.18 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.82 Typical High $3.63 | Professional | None | $1.91 | $2.82 | $3.63 |
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 $1.74 Median $3.72 Typical High $3.80 | Professional | 52 · Reduced service | $1.74 | $3.72 | $3.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $1.48 Typical High $1.51 | Professional | 53 · Discontinued | $0.69 | $1.48 | $1.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.57 Median $5.50 Typical High $5.62 | Professional | 54 · Surgery only | $2.57 | $5.50 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $1.12 Typical High $1.12 | Professional | 55 · Aftercare only | $0.52 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.74 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.35 | $0.74 | $0.76 |
Where Kansas sits
The same service costs 3.0 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
$3.47
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.