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 $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $15.85 Typical High $15.85 | Professional | None | $15.49 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.16 Typical High $3.16 | Professional | 53 · Discontinued | $3.09 | $3.16 | $3.16 |
BCBS Wyoming Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
BCBS Wyoming Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.30 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.59 Typical High $8.32 | Professional | None | $7.24 | $7.59 | $8.32 |
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 $7.76 Median $7.94 Typical High $7.94 | Professional | 52 · Reduced service | $7.76 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.48 Median $11.75 Typical High $11.75 | Professional | 54 · Surgery only | $11.48 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.34 Typical High $2.34 | Professional | 55 · Aftercare only | $2.29 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.58 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.55 | $1.58 | $1.58 |
Where Wyoming sits
The same service costs 2.7 times more in Idaho 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· 6th of 51
$17.78
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.