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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $30.20 Typical High $30.90 | Professional | None | $14.13 | $30.20 | $30.90 |
BCBS Kansas Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $47.86 | Facility | None | $19.50 | $19.50 | $47.86 |
Medica Setting Professional Modifier None Typical Low $9.77 Median $11.75 Typical High $269.15 | Professional | None | $9.77 | $11.75 | $269.15 |
United Setting Professional Modifier None Typical Low $7.76 Median $11.75 Typical High $14.79 | Professional | None | $7.76 | $11.75 | $14.79 |
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 $7.08 Median $15.14 Typical High $15.49 | Professional | 52 · Reduced service | $7.08 | $15.14 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $6.03 Typical High $6.17 | Professional | 53 · Discontinued | $2.82 | $6.03 | $6.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $22.91 Typical High $22.91 | Professional | 54 · Surgery only | $10.72 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $2.14 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $3.02 Typical High $3.09 | Professional | 56 · Pre-op care only | $1.41 | $3.02 | $3.09 |
Where Kansas sits
The same service costs 2.9 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· 32nd of 51
$14.13
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.