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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $75.86 | Professional | None | $69.18 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $15.14 | Professional | 53 · Discontinued | $13.80 | $13.80 | $15.14 |
BCBS Wyoming Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $60.26 | Professional | None | $51.29 | $60.26 | $60.26 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $35.48 | $41.69 | $41.69 |
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 $33.88 Median $33.88 Typical High $38.02 | Professional | 52 · Reduced service | $33.88 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $11.22 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $7.59 |
Where Wyoming sits
The same service costs 2.7 times more in North Dakota than in North Carolina. 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· 49th of 51
$60.26
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.