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 $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $23.44 Typical High $23.99 | Professional | None | $10.96 | $23.44 | $23.99 |
BCBS Kansas Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Medica Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $36.31 | Facility | None | $15.14 | $15.14 | $36.31 |
Medica Setting Professional Modifier None Typical Low $7.59 Median $8.91 Typical High $151.36 | Professional | None | $7.59 | $8.91 | $151.36 |
United Setting Professional Modifier None Typical Low $6.03 Median $8.91 Typical High $11.48 | Professional | None | $6.03 | $8.91 | $11.48 |
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 $5.50 Median $11.75 Typical High $12.02 | Professional | 52 · Reduced service | $5.50 | $11.75 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $4.68 Typical High $4.79 | Professional | 53 · Discontinued | $2.19 | $4.68 | $4.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.32 Median $17.38 Typical High $17.78 | Professional | 54 · Surgery only | $8.32 | $17.38 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $1.66 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $2.34 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.10 | $2.34 | $2.40 |
Where Kansas sits
The same service costs 2.7 times more in Idaho 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· 27th of 51
$10.96
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.