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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | None | $109.65 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $21.88 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $16.60 | $16.98 | $16.98 |
BCBS Wyoming Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $15.14 Median $61.66 Typical High $64.57 | Professional | None | $15.14 | $61.66 | $64.57 |
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 $54.95 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $54.95 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.96 | $11.22 | $11.22 |
Where Wyoming sits
The same service costs 2.9 times more in Hawaii than in New York. 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
$112
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.