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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $77.62 | Professional | None | $60.26 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $13.18 | Professional | 53 · Discontinued | $12.02 | $12.02 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $10.00 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $10.00 |
BCBS Wyoming Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | None | $87.10 | $102.33 | $102.33 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $60.26 | $70.79 | $70.79 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $17.38 | $20.42 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $223.87 | Facility | None | $112.20 | $112.20 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $85.11 | Professional | None | $60.26 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
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 $30.20 Median $30.20 Typical High $33.11 | Professional | 52 · Reduced service | $30.20 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.61 |
Where Wyoming sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 7th of 51
$87.10
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.