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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | None | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $16.60 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.30 | $12.88 | $12.88 |
BCBS Wyoming Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
United Setting Professional Modifier None Typical Low $15.14 Median $46.77 Typical High $46.77 | Professional | None | $15.14 | $46.77 | $46.77 |
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 $40.74 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $40.74 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.13 | $8.71 | $8.71 |
Where Wyoming sits
The same service costs 2.3 times more in Hawaii than in Utah. 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· 9th of 51
$87.10
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.