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 $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $3.80 Typical High $3.80 | Professional | None | $3.16 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.78 Typical High $0.78 | Professional | 53 · Discontinued | $0.76 | $0.78 | $0.78 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
BCBS Wyoming Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 53 · Discontinued | $3.02 | $3.02 | $3.02 |
BCBS Wyoming Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | AU · Urologic/ostomy supply | $4.27 | $4.27 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
United Setting Professional Modifier None Typical Low $1.70 Median $1.86 Typical High $1.86 | Professional | None | $1.70 | $1.86 | $1.86 |
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 $1.86 Median $1.91 Typical High $1.91 | Professional | 52 · Reduced service | $1.86 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.58 Typical High $0.58 | Professional | 55 · Aftercare only | $0.56 | $0.58 | $0.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.38 | $0.38 | $0.38 |
Where Wyoming sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 24th of 51
$2.24
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.