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 $23.44 Median $23.44 Typical High $39.81 | Facility | None | $23.44 | $23.44 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $37.15 Typical High $43.65 | Professional | None | $23.44 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $7.41 Typical High $8.71 | Professional | 53 · Discontinued | $4.68 | $7.41 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $5.62 Typical High $6.61 | Professional | 55 · Aftercare only | $3.55 | $5.62 | $6.61 |
BCBS Wyoming Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $70.79 | Professional | None | $40.74 | $40.74 | $70.79 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $50.12 | Professional | 53 · Discontinued | $28.84 | $28.84 | $50.12 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $14.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $33.11 Typical High $40.74 | Professional | None | $19.50 | $33.11 | $40.74 |
United Setting Professional Modifier None Typical Low $31.62 Median $43.65 Typical High $69.18 | Professional | None | $31.62 | $43.65 | $69.18 |
2 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 $11.75 Median $18.62 Typical High $21.88 | Professional | 52 · Reduced service | $11.75 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $3.72 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.34 | $3.72 | $4.37 |
Where Wyoming sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 12th of 51
$40.74
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.