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 $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $15.14 Typical High $15.49 | Professional | None | $7.08 | $15.14 | $15.49 |
BCBS Kansas Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Medica Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $23.44 | Facility | None | $9.77 | $9.77 | $23.44 |
Medica Setting Professional Modifier None Typical Low $4.90 Median $5.75 Typical High $138.04 | Professional | None | $4.90 | $5.75 | $138.04 |
United Setting Professional Modifier None Typical Low $3.89 Median $5.75 Typical High $7.41 | Professional | None | $3.89 | $5.75 | $7.41 |
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 $3.55 Median $7.59 Typical High $7.76 | Professional | 52 · Reduced service | $3.55 | $7.59 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $3.02 Typical High $3.09 | Professional | 53 · Discontinued | $1.41 | $3.02 | $3.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.37 Median $11.48 Typical High $11.48 | Professional | 54 · Surgery only | $5.37 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $2.29 Typical High $2.29 | Professional | 55 · Aftercare only | $1.07 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $1.51 Typical High $1.55 | Professional | 56 · Pre-op care only | $0.71 | $1.51 | $1.55 |
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· 29th of 51
$7.08
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.