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 $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $22.39 Typical High $22.39 | Professional | None | $21.88 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $4.37 | $4.47 | $4.47 |
BCBS Wyoming Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
BCBS Wyoming Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $17.38 | $17.38 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.96 Typical High $11.75 | Professional | None | $10.47 | $10.96 | $11.75 |
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 $10.96 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $10.96 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.60 Median $16.98 Typical High $16.98 | Professional | 54 · Surgery only | $16.60 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $3.31 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.19 | $2.24 | $2.24 |
Where Wyoming sits
The same service costs 3.5 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· 7th of 51
$25.12
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.