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 $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.91 | Professional | None | $8.13 | $8.13 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.74 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.32 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.32 |
BCBS Wyoming Setting Professional Modifier None Typical Low $35.48 Median $41.69 Typical High $41.69 | Professional | None | $35.48 | $41.69 | $41.69 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $25.12 | $29.51 | $29.51 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $7.08 | $8.32 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $30.90 | Facility | None | $15.49 | $15.49 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $11.48 Typical High $11.48 | Professional | None | $8.13 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
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 $4.07 Median $4.07 Typical High $4.37 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.87 |
Where Wyoming sits
The same service costs 1.9 times more in Wyoming than in Georgia. 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· 1st of 51
$15.49
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.