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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.84 Typical High $28.84 | Professional | None | $28.18 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.75 |
BCBS Wyoming Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
BCBS Wyoming Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
United Setting Professional Modifier None Typical Low $13.49 Median $14.13 Typical High $15.14 | Professional | None | $13.49 | $14.13 | $15.14 |
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 $14.13 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.13 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $21.88 Typical High $21.88 | Professional | 54 · Surgery only | $21.38 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.27 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.82 | $2.88 | $2.88 |
Where Wyoming sits
The same service costs 2.6 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· 8th of 51
$32.36
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.