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 $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.27 | Professional | None | $4.07 | $4.07 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $0.81 Typical High $0.85 | Professional | 53 · Discontinued | $0.81 | $0.81 | $0.85 |
BCBS Wyoming Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
BCBS Wyoming Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
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 $2.04 Median $2.04 Typical High $2.14 | Professional | 52 · Reduced service | $2.04 | $2.04 | $2.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.41 | $0.41 | $0.41 |
Where Wyoming sits
The same service costs 6.9 times more in Montana than in Indiana. 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· 3rd of 51
$26.30
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.