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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $72.44 | Professional | None | $63.10 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $12.59 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $9.33 | $10.96 | $10.96 |
BCBS Wyoming Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
United Setting Professional Modifier None Typical Low $12.88 Median $36.31 Typical High $36.31 | Professional | None | $12.88 | $36.31 | $36.31 |
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 $31.62 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $31.62 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.31 | $7.24 | $7.24 |
Where Wyoming sits
The same service costs 2.9 times more in Hawaii than in Indiana. 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· 5th of 51
$72.44
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.