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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $114.82 | Professional | None | $104.71 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $22.91 | Professional | 53 · Discontinued | $20.89 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $17.38 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $17.38 |
BCBS Wyoming Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $239.88 | Professional | None | $204.17 | $239.88 | $239.88 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $169.82 | $169.82 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $40.74 | $47.86 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $398.11 | Facility | None | $199.53 | $199.53 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $147.91 | Professional | None | $104.71 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $52.48 Median $52.48 Typical High $57.54 | Professional | 52 · Reduced service | $52.48 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $11.48 |
Where Wyoming sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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
$204
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.