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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | None | $120.23 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $24.55 | $25.12 | $25.12 |
BCBS Wyoming Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $67.61 | Professional | None | $60.26 | $60.26 | $67.61 |
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 $60.26 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $60.26 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.20 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $12.59 |
Where Wyoming sits
The same service costs 3.4 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· 9th of 51
$126
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.