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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $32.36 Typical High $33.11 | Professional | None | $15.14 | $32.36 | $33.11 |
BCBS Kansas Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Medica Setting Facility Modifier None Typical Low $19.95 Median $20.89 Typical High $51.29 | Facility | None | $19.95 | $20.89 | $51.29 |
Medica Setting Professional Modifier None Typical Low $10.47 Median $12.59 Typical High $199.53 | Professional | None | $10.47 | $12.59 | $199.53 |
United Setting Professional Modifier None Typical Low $8.32 Median $12.59 Typical High $15.85 | Professional | None | $8.32 | $12.59 | $15.85 |
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 $7.59 Median $16.22 Typical High $16.60 | Professional | 52 · Reduced service | $7.59 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $6.46 Typical High $6.61 | Professional | 53 · Discontinued | $3.02 | $6.46 | $6.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.48 Median $24.55 Typical High $24.55 | Professional | 54 · Surgery only | $11.48 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $2.29 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $3.24 Typical High $3.31 | Professional | 56 · Pre-op care only | $1.51 | $3.24 | $3.31 |
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· 31st of 51
$15.14
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.