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 $2.88 Median $2.88 Typical High $2.88 | Facility | None | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.24 | Professional | None | $2.88 | $2.88 | $3.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $0.63 | Professional | 53 · Discontinued | $0.58 | $0.58 | $0.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.48 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.48 |
BCBS Setting Professional Modifier None Typical Low $10.00 Median $12.02 Typical High $12.02 | Professional | None | $10.00 | $12.02 | $12.02 |
BCBS Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $7.08 | $8.32 | $8.32 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $2.04 | $2.40 | $2.40 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $10.96 | Facility | None | $5.50 | $5.50 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $4.07 Typical High $4.07 | Professional | None | $2.88 | $4.07 | $4.07 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
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 $1.45 Median $1.45 Typical High $1.58 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.32 |
Where Wyoming sits
The same service costs 3.5 times more in Wyoming than in Ohio. 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
$10.00
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.