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 $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $18.62 Typical High $18.62 | Professional | None | $17.78 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.55 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.63 | $2.75 | $2.75 |
BCBS Wyoming Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $14.45 | $14.45 | $14.45 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
United Setting Professional Modifier None Typical Low $6.03 Median $10.00 Typical High $12.02 | Professional | None | $6.03 | $10.00 | $12.02 |
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 $8.71 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $8.71 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.78 | $1.86 | $1.86 |
Where Wyoming sits
The same service costs 3.2 times more in Montana 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
$18.62
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.