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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.76 Typical High $7.76 | Professional | 53 · Discontinued | $7.59 | $7.76 | $7.76 |
BCBS Wyoming Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
BCBS Wyoming Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $17.78 Median $18.62 Typical High $20.42 | Professional | None | $17.78 | $18.62 | $20.42 |
4 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 $19.05 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $28.84 Typical High $28.84 | Professional | 54 · Surgery only | $28.18 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $5.62 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.80 |
Where Wyoming sits
The same service costs 2.7 times more in Hawaii than in New York. 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· 7th of 51
$42.66
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.