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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $19.95 Typical High $19.95 | Professional | None | $9.33 | $19.95 | $19.95 |
Ambetter Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
BCBS Kansas Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Medica Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $34.67 | Facility | None | $12.59 | $12.59 | $34.67 |
Medica Setting Professional Modifier None Typical Low $6.46 Median $7.59 Typical High $295.12 | Professional | None | $6.46 | $7.59 | $295.12 |
United Setting Professional Modifier None Typical Low $5.01 Median $7.59 Typical High $9.55 | Professional | None | $5.01 | $7.59 | $9.55 |
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 $4.68 Median $9.77 Typical High $10.00 | Professional | 52 · Reduced service | $4.68 | $9.77 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $3.98 Typical High $3.98 | Professional | 53 · Discontinued | $1.86 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.92 Median $14.79 Typical High $15.14 | Professional | 54 · Surgery only | $6.92 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $2.95 Typical High $3.02 | Professional | 55 · Aftercare only | $1.38 | $2.95 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $2.00 Typical High $2.00 | Professional | 56 · Pre-op care only | $0.93 | $2.00 | $2.00 |
Where Kansas sits
The same service costs 4.5 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· 32nd of 51
$9.33
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.