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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $61.66 Typical High $61.66 | Professional | None | $28.84 | $61.66 | $61.66 |
BCBS Kansas Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $95.50 | Facility | None | $38.90 | $38.90 | $95.50 |
Medica Setting Professional Modifier None Typical Low $19.95 Median $23.44 Typical High $616.60 | Professional | None | $19.95 | $23.44 | $616.60 |
United Setting Professional Modifier None Typical Low $15.85 Median $23.44 Typical High $29.51 | Professional | None | $15.85 | $23.44 | $29.51 |
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 $14.45 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $14.45 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $12.30 Typical High $12.59 | Professional | 53 · Discontinued | $5.75 | $12.30 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $45.71 Typical High $46.77 | Professional | 54 · Surgery only | $21.38 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $9.12 Typical High $9.33 | Professional | 55 · Aftercare only | $4.37 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $2.88 | $6.17 | $6.17 |
Where Kansas sits
The same service costs 3.2 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· 28th of 51
$28.84
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.