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 $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $17.38 Typical High $17.38 | Professional | None | $16.98 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.39 | $3.47 | $3.47 |
BCBS Wyoming Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
BCBS Wyoming Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $7.94 Median $8.32 Typical High $9.12 | Professional | None | $7.94 | $8.32 | $9.12 |
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 $8.51 Median $8.71 Typical High $8.71 | Professional | 52 · Reduced service | $8.51 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.59 Median $12.88 Typical High $12.88 | Professional | 54 · Surgery only | $12.59 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.51 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.70 | $1.74 | $1.74 |
Where Wyoming sits
The same service costs 2.8 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
$19.05
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.