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 $3.72 Median $3.72 Typical High $3.72 | Facility | None | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.72 Typical High $3.72 | Professional | None | $3.63 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.74 Typical High $0.74 | Professional | 53 · Discontinued | $0.72 | $0.74 | $0.74 |
BCBS Wyoming Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Facility | None | $4.17 | $4.17 | $4.17 |
BCBS Wyoming Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 53 · Discontinued | $2.88 | $2.88 | $2.88 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
United Setting Professional Modifier None Typical Low $1.70 Median $1.78 Typical High $1.95 | Professional | None | $1.70 | $1.78 | $1.95 |
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 $1.82 Median $1.86 Typical High $1.86 | Professional | 52 · Reduced service | $1.82 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 54 · Surgery only | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.55 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.55 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.37 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.36 | $0.37 | $0.37 |
Where Wyoming sits
The same service costs 4.0 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· 9th of 51
$4.17
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.