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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | None | $10.72 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $2.14 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.62 | $1.66 | $1.66 |
BCBS Wyoming Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $2.45 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
United Setting Professional Modifier None Typical Low $5.01 Median $6.17 Typical High $8.91 | Professional | None | $5.01 | $6.17 | $8.91 |
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 $5.37 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $5.37 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.07 | $1.10 | $1.10 |
Where Wyoming sits
The same service costs 2.7 times more in Montana than in Utah. 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· 17th of 51
$10.96
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.