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 $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.29 |
BCBS Wyoming Setting Professional Modifier None Typical Low $16.22 Median $19.05 Typical High $19.05 | Professional | None | $16.22 | $19.05 | $19.05 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $11.48 | $13.49 | $13.49 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $3.24 | $3.80 | $3.80 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $32.36 | Facility | None | $16.22 | $16.22 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $12.30 Typical High $12.30 | Professional | None | $8.71 | $12.30 | $12.30 |
United Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
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 $4.37 Median $4.37 Typical High $4.37 | Professional | 52 · Reduced service | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $0.87 |
Where Wyoming sits
The same service costs 1.9 times more in Wyoming than in Mississippi. 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
$16.22
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.