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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $37.15 | Professional | None | $36.31 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $7.24 | $7.41 | $7.41 |
BCBS Wyoming Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
BCBS Wyoming Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
United Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $19.50 | Professional | None | $17.38 | $18.20 | $19.50 |
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 $18.20 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.20 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $28.18 Typical High $28.18 | Professional | 54 · Surgery only | $27.54 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.50 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.63 | $3.72 | $3.72 |
Where Wyoming sits
The same service costs 2.8 times more in Hawaii 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
$41.69
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.