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 $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $43.65 Typical High $44.67 | Professional | None | $20.42 | $43.65 | $44.67 |
BCBS Kansas Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $28.18 Typical High $67.61 | Facility | None | $25.70 | $28.18 | $67.61 |
Medica Setting Professional Modifier None Typical Low $14.13 Median $16.98 Typical High $257.04 | Professional | None | $14.13 | $16.98 | $257.04 |
United Setting Professional Modifier None Typical Low $11.22 Median $16.98 Typical High $21.38 | Professional | None | $11.22 | $16.98 | $21.38 |
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 $10.23 Median $21.88 Typical High $22.39 | Professional | 52 · Reduced service | $10.23 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $8.71 Typical High $8.91 | Professional | 53 · Discontinued | $4.07 | $8.71 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $33.11 Typical High $33.11 | Professional | 54 · Surgery only | $15.49 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $3.09 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $4.37 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.04 | $4.37 | $4.47 |
Where Kansas sits
The same service costs 2.8 times more in Hawaii 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· 29th of 51
$20.42
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.