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 Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $38.90 | Professional | None | $36.31 | $36.31 | $38.90 |
BCBS Kansas Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $53.70 Typical High $1,000.00 | Facility | None | $36.31 | $53.70 | $1,000.00 |
United Setting Professional Modifier None Typical Low $12.02 Median $12.88 Typical High $42.66 | Professional | None | $12.02 | $12.88 | $42.66 |
4 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 $18.20 Median $18.20 Typical High $19.50 | Professional | 52 · Reduced service | $18.20 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.76 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $5.75 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.89 |
Where Kansas sits
The same service costs 7.8 times more in Montana than in Nebraska. 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· 6th of 51
$47.86
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.