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 $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $20.42 Typical High $20.42 | Professional | None | $15.14 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $3.98 | $4.07 | $4.07 |
BCBS Wyoming Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
BCBS Wyoming Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
United Setting Professional Modifier None Typical Low $9.33 Median $9.77 Typical High $10.72 | Professional | None | $9.33 | $9.77 | $10.72 |
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 $10.00 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $10.00 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 54 · Surgery only | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $3.02 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $2.00 | $2.04 | $2.04 |
Where Wyoming sits
The same service costs 2.9 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· 8th of 51
$22.91
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.