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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | None | $66.07 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $13.18 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $10.23 |
BCBS Wyoming Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $53.70 | $53.70 | $53.70 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $19.05 Median $34.67 Typical High $39.81 | Professional | None | $19.05 | $34.67 | $39.81 |
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 $33.11 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $33.11 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.61 | $6.92 | $6.92 |
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· 7th of 51
$69.18
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.