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 $7.41 Median $7.41 Typical High $7.41 | Facility | None | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $7.41 Typical High $7.41 | Professional | None | $7.24 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.48 Typical High $1.48 | Professional | 53 · Discontinued | $1.45 | $1.48 | $1.48 |
BCBS Wyoming Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
BCBS Wyoming Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
BCBS Wyoming 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 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.55 Typical High $3.89 | Professional | None | $3.39 | $3.55 | $3.89 |
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 $3.63 Median $3.72 Typical High $3.72 | Professional | 52 · Reduced service | $3.63 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.37 Median $5.50 Typical High $5.50 | Professional | 54 · Surgery only | $5.37 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.12 Typical High $1.12 | Professional | 55 · Aftercare only | $1.07 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.74 Typical High $0.74 | Professional | 56 · Pre-op care only | $0.72 | $0.74 | $0.74 |
Where Wyoming sits
The same service costs 4.1 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· 9th of 51
$8.13
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.