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 $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $13.18 Typical High $16.22 | Professional | None | $12.88 | $13.18 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | 53 · Discontinued | $2.63 | $2.63 | $2.63 |
BCBS Wyoming Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
BCBS Wyoming Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $10.47 | $10.47 | $10.47 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
United Setting Professional Modifier None Typical Low $6.17 Median $6.46 Typical High $7.08 | Professional | None | $6.17 | $6.46 | $7.08 |
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 $6.46 Median $6.61 Typical High $6.61 | Professional | 52 · Reduced service | $6.46 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.77 Median $10.00 Typical High $10.00 | Professional | 54 · Surgery only | $9.77 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.00 Typical High $2.00 | Professional | 55 · Aftercare only | $1.95 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.29 | $1.32 | $1.32 |
Where Wyoming sits
The same service costs 4.5 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
$14.79
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.