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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $67.61 | Professional | None | $64.57 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $12.88 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $9.77 | $10.00 | $10.00 |
BCBS Wyoming Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
United Setting Professional Modifier None Typical Low $10.96 Median $36.31 Typical High $37.15 | Professional | None | $10.96 | $36.31 | $37.15 |
2 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 $32.36 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $32.36 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.46 | $6.61 | $6.61 |
Where Wyoming sits
The same service costs 2.6 times more in Montana than in Nebraska. 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
$67.61
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.