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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | None | $30.90 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.46 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.46 |
BCBS Wyoming Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $38.90 | Professional | None | $33.11 | $38.90 | $38.90 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $23.44 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
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 $15.49 Median $15.49 Typical High $16.22 | Professional | 52 · Reduced service | $15.49 | $15.49 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.90 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.24 |
Where Wyoming sits
The same service costs 5.6 times more in Alaska 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· 13th of 51
$33.11
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.