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 $25.12 Median $25.12 Typical High $32.36 | Facility | None | $25.12 | $25.12 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $30.90 Typical High $61.66 | Professional | None | $24.55 | $30.90 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $6.17 Typical High $12.30 | Professional | 53 · Discontinued | $4.90 | $6.17 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.68 Typical High $9.33 | Professional | 55 · Aftercare only | $3.72 | $4.68 | $9.33 |
BCBS Wyoming Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
BCBS Wyoming Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $104.71 | Professional | None | $50.12 | $79.43 | $104.71 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $56.23 Typical High $72.44 | Professional | 53 · Discontinued | $34.67 | $56.23 | $72.44 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $15.85 Typical High $20.89 | Professional | 55 · Aftercare only | $10.00 | $15.85 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $23.44 Median $38.02 Typical High $54.95 | Facility | None | $23.44 | $38.02 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $81.28 | Professional | None | $33.88 | $51.29 | $81.28 |
United Setting Facility Modifier None Typical Low $223.87 Median $295.12 Typical High $3,090.30 | Facility | None | $223.87 | $295.12 | $3,090.30 |
United Setting Professional Modifier None Typical Low $35.48 Median $52.48 Typical High $114.82 | Professional | None | $35.48 | $52.48 | $114.82 |
3 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 $12.30 Median $15.49 Typical High $30.90 | Professional | 52 · Reduced service | $12.30 | $15.49 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $23.44 Typical High $45.71 | Professional | 54 · Surgery only | $18.62 | $23.44 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.09 Typical High $6.17 | Professional | 56 · Pre-op care only | $2.45 | $3.09 | $6.17 |
Where Wyoming sits
The same service costs 3.5 times more in Alaska than in Maryland. 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.
Wyoming· 4th of 51
$64.57
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.