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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | None | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $15.85 | $16.22 | $16.22 |
BCBS Wyoming Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
United Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $36.31 | Professional | None | $33.11 | $36.31 | $36.31 |
3 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 $39.81 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $39.81 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $11.75 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.94 | $8.13 | $8.13 |
Where Wyoming sits
The same service costs 2.8 times more in Montana than in Alabama. 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· 6th of 51
$81.28
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.