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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $33.11 Typical High $33.88 | Professional | None | $15.85 | $33.11 | $33.88 |
BCBS Kansas Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Medica Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $52.48 | Facility | None | $21.38 | $21.38 | $52.48 |
Medica Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $363.08 | Professional | None | $10.96 | $12.88 | $363.08 |
United Setting Professional Modifier None Typical Low $8.51 Median $12.88 Typical High $16.22 | Professional | None | $8.51 | $12.88 | $16.22 |
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 $7.76 Median $16.60 Typical High $16.98 | Professional | 52 · Reduced service | $7.76 | $16.60 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $3.16 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.75 Median $25.12 Typical High $25.70 | Professional | 54 · Surgery only | $11.75 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $5.01 Typical High $5.13 | Professional | 55 · Aftercare only | $2.34 | $5.01 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $3.31 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.58 | $3.31 | $3.39 |
Where Kansas sits
The same service costs 3.5 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· 31st of 51
$15.85
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.