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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $79.43 | Professional | None | $70.79 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $15.85 | Professional | 53 · Discontinued | $14.45 | $14.45 | $15.85 |
BCBS Wyoming Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $104.71 | Professional | None | $89.13 | $104.71 | $104.71 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $61.66 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $302.00 Typical High $478.63 | Facility | None | $190.55 | $302.00 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $181.97 | Professional | None | $125.89 | $181.97 | $181.97 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
3 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 $35.48 Median $35.48 Typical High $39.81 | Professional | 52 · Reduced service | $35.48 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $11.75 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.94 |
Where Wyoming sits
The same service costs 2.0 times more in North Dakota than in Maryland. 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· 25th of 51
$105
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.