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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | None | $107.15 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $23.44 | Professional | 53 · Discontinued | $21.38 | $21.38 | $23.44 |
BCBS Wyoming Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $562.34 | Professional | None | $478.63 | $562.34 | $562.34 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $338.84 | $398.11 | $398.11 |
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 $53.70 Median $53.70 Typical High $58.88 | Professional | 52 · Reduced service | $53.70 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $17.78 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $11.75 |
Where Wyoming sits
The same service costs 6.0 times more in Wyoming than in Montana. 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· 1st of 51
$479
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.