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 $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $5.50 Typical High $5.62 | Professional | None | $2.57 | $5.50 | $5.62 |
BCBS Kansas Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Medica Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $8.51 | Facility | None | $3.55 | $3.55 | $8.51 |
Medica Setting Professional Modifier None Typical Low $1.78 Median $2.09 Typical High $69.18 | Professional | None | $1.78 | $2.09 | $69.18 |
United Setting Professional Modifier None Typical Low $1.41 Median $2.09 Typical High $2.69 | Professional | None | $1.41 | $2.09 | $2.69 |
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 $1.29 Median $2.75 Typical High $2.82 | Professional | 52 · Reduced service | $1.29 | $2.75 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $1.10 Typical High $1.12 | Professional | 53 · Discontinued | $0.52 | $1.10 | $1.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.95 Median $4.17 Typical High $4.17 | Professional | 54 · Surgery only | $1.95 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.39 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.55 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.26 | $0.55 | $0.56 |
Where Kansas sits
The same service costs 4.0 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· 31st of 51
$2.57
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.