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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | None | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $39.81 | Professional | 53 · Discontinued | $36.31 | $36.31 | $39.81 |
BCBS Wyoming Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $501.19 | Professional | None | $426.58 | $501.19 | $501.19 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $295.12 | $346.74 | $346.74 |
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 |
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 $91.20 Median $91.20 Typical High $100.00 | Professional | 52 · Reduced service | $91.20 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $151.36 | Professional | 54 · Surgery only | $138.04 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $30.20 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $19.95 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $19.95 |
Where Wyoming sits
The same service costs 3.6 times more in Wyoming 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· 1st of 51
$427
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.