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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | None | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $18.20 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $13.80 | $15.49 | $15.49 |
BCBS Wyoming Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
United Setting Professional Modifier None Typical Low $12.88 Median $47.86 Typical High $50.12 | Professional | None | $12.88 | $47.86 | $50.12 |
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 $45.71 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $45.71 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $9.12 | $10.23 | $10.23 |
Where Wyoming sits
The same service costs 2.6 times more in Hawaii than in Ohio. 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
$102
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.