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 $6.31 Median $6.31 Typical High $6.31 | Facility | None | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $6.17 Median $6.31 Typical High $6.31 | Professional | None | $6.17 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.26 Typical High $1.26 | Professional | 53 · Discontinued | $1.23 | $1.26 | $1.26 |
BCBS Wyoming Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
BCBS Wyoming Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $4.90 | $4.90 | $4.90 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $2.95 Median $3.09 Typical High $3.31 | Professional | None | $2.95 | $3.09 | $3.31 |
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 $3.09 Median $3.16 Typical High $3.16 | Professional | 52 · Reduced service | $3.09 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.68 Median $4.79 Typical High $4.79 | Professional | 54 · Surgery only | $4.68 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.93 Median $0.95 Typical High $0.95 | Professional | 55 · Aftercare only | $0.93 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.63 Typical High $0.63 | Professional | 56 · Pre-op care only | $0.62 | $0.63 | $0.63 |
Where Wyoming sits
The same service costs 2.7 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
$7.08
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.