How much rates vary
Facilitymedian $13 · 10th to 90th $13 to $13Professionalmedian $62 · 10th to 90th $13 to $62
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 $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $19.95 | Professional | None | $13.49 | $13.49 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $2.95 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $2.95 |
BCBS Wyoming Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $42.66 | $42.66 | $42.66 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.30 |
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 $6.76 Median $6.76 Typical High $9.77 | Professional | 52 · Reduced service | $6.76 | $6.76 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.35 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.35 | $1.35 | $1.95 |