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 $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $7.08 Typical High $10.47 | Professional | None | $6.92 | $7.08 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.41 Typical High $1.41 | Professional | 53 · Discontinued | $1.38 | $1.41 | $1.41 |
BCBS Wyoming Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
BCBS Wyoming Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 53 · Discontinued | $5.50 | $5.50 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.47 Typical High $3.72 | Professional | None | $3.24 | $3.47 | $3.72 |
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 $3.47 Median $3.55 Typical High $3.55 | Professional | 52 · Reduced service | $3.47 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.25 Median $5.37 Typical High $5.37 | Professional | 54 · Surgery only | $5.25 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.05 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $1.05 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.69 Median $0.71 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.69 | $0.71 | $0.71 |
Where Wyoming sits
The same service costs 3.2 times more in Rhode Island 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· 8th of 51
$7.94
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.