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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | None | $234.42 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $46.77 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $35.48 | $38.02 | $38.02 |
BCBS Wyoming Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $134.90 | Professional | None | $120.23 | $134.90 | $134.90 |
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 $117.49 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $23.44 | $25.70 | $25.70 |
Where Wyoming sits
The same service costs 3.2 times more in Minnesota 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· 7th of 51
$257
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.