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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.90 | Professional | None | $38.02 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.76 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.76 |
BCBS Wyoming Setting Professional Modifier None Typical Low $39.81 Median $46.77 Typical High $46.77 | Professional | None | $39.81 | $46.77 | $46.77 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $28.18 | $33.11 | $33.11 |
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 $19.05 Median $19.05 Typical High $19.50 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.89 |
Where Wyoming sits
The same service costs 4.8 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· 43rd of 51
$46.77
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.