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 $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.68 | Professional | None | $4.27 | $4.27 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.93 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.65 Typical High $0.71 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $0.71 |
BCBS Wyoming Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $25.70 | Professional | None | $21.88 | $25.70 | $25.70 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $15.49 | $18.20 | $18.20 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $4.37 | $5.13 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $16.22 | Facility | None | $8.13 | $8.13 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $6.03 Typical High $6.03 | Professional | None | $4.27 | $6.03 | $6.03 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
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 $2.14 Median $2.14 Typical High $2.34 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $0.47 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $0.47 |
Where Wyoming sits
The same service costs 5.1 times more in Wyoming than in Alabama. 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
$21.88
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.