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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
BCBS Wyoming Setting Professional Modifier None Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | None | $47.86 | $56.23 | $56.23 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $33.88 | $39.81 | $39.81 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $9.55 | $11.22 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $138.04 | Facility | None | $69.18 | $69.18 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $51.29 Typical High $51.29 | Professional | None | $36.31 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
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 $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
Where Wyoming sits
Rates are fairly even across states for this service. 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· 2nd of 51
$47.86
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.