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 $5.01 Median $5.01 Typical High $5.01 | Facility | None | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $4.90 Median $5.01 Typical High $5.01 | Professional | None | $4.90 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $1.00 Typical High $1.00 | Professional | 53 · Discontinued | $0.98 | $1.00 | $1.00 |
BCBS Wyoming Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
BCBS Wyoming Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.89 | $3.89 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
United Setting Professional Modifier None Typical Low $2.29 Median $2.40 Typical High $2.63 | Professional | None | $2.29 | $2.40 | $2.63 |
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 $2.45 Median $2.51 Typical High $2.51 | Professional | 52 · Reduced service | $2.45 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.63 Median $3.72 Typical High $3.72 | Professional | 54 · Surgery only | $3.63 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.76 Typical High $0.76 | Professional | 55 · Aftercare only | $0.72 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $0.50 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.49 | $0.50 | $0.50 |
Where Wyoming sits
The same service costs 3.0 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
$5.62
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.