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 $0.68 Median $0.68 Typical High $0.68 | Facility | None | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | None | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.13 | $0.14 | $0.14 |
BCBS Wyoming Setting Facility Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Facility | None | $0.76 | $0.76 | $0.76 |
BCBS Wyoming Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 53 · Discontinued | $0.52 | $0.52 | $0.52 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
United Setting Professional Modifier None Typical Low $0.30 Median $0.33 Typical High $0.33 | Professional | None | $0.30 | $0.33 | $0.33 |
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 $0.34 Median $0.34 Typical High $0.34 | Professional | 52 · Reduced service | $0.34 | $0.34 | $0.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Where Wyoming sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 6th of 51
$0.76
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.