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 $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $10.23 Typical High $10.23 | Professional | None | $7.59 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.04 Typical High $2.04 | Professional | 53 · Discontinued | $2.00 | $2.04 | $2.04 |
BCBS Wyoming Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
BCBS Wyoming Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.94 | $7.94 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
United Setting Professional Modifier None Typical Low $4.68 Median $4.90 Typical High $5.37 | Professional | None | $4.68 | $4.90 | $5.37 |
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 $5.01 Median $5.13 Typical High $5.13 | Professional | 52 · Reduced service | $5.01 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 54 · Surgery only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.02 Typical High $1.02 | Professional | 56 · Pre-op care only | $1.00 | $1.02 | $1.02 |
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
$11.48
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.