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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | None | $85.11 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $16.98 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $12.59 | $14.45 | $14.45 |
BCBS Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
BCBS Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $75.86 | $75.86 | $75.86 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
United Setting Professional Modifier None Typical Low $15.14 Median $47.86 Typical High $47.86 | Professional | None | $15.14 | $47.86 | $47.86 |
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 $41.69 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $41.69 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $8.51 | $9.77 | $9.77 |
Where Wyoming sits
The same service costs 2.5 times more in Montana 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
$97.72
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.