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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | None | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $19.95 | Professional | 53 · Discontinued | $19.50 | $19.50 | $19.95 |
BCBS Wyoming Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $120.23 | Professional | None | $102.33 | $120.23 | $120.23 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $72.44 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $478.63 | Facility | None | $239.88 | $239.88 | $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 $47.86 Median $47.86 Typical High $50.12 | Professional | 52 · Reduced service | $47.86 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $15.14 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $10.00 |
Where Wyoming sits
The same service costs 1.9 times more in North Dakota than in Hawaii. 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· 33rd of 51
$120
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.