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 $263.03 Median $263.03 Typical High $380.19 | Facility | None | $263.03 | $263.03 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $524.81 | Professional | None | $263.03 | $380.19 | $524.81 |
BCBS Wyoming Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
BCBS Wyoming Setting Professional Modifier None Typical Low $501.19 Median $758.58 Typical High $1,096.48 | Professional | None | $501.19 | $758.58 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $676.08 Typical High $954.99 | Facility | None | $407.38 | $676.08 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $794.33 | Professional | None | $346.74 | $467.74 | $794.33 |
United Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $3,162.28 | Facility | None | $501.19 | $794.33 | $3,162.28 |
United Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $1,023.29 | Professional | None | $323.59 | $575.44 | $1,023.29 |
6 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 $131.83 Median $186.21 Typical High $263.03 | Professional | 52 · Reduced service | $131.83 | $186.21 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $74.13 Typical High $104.71 | Professional | 53 · Discontinued | $52.48 | $74.13 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $275.42 Typical High $398.11 | Professional | 54 · Surgery only | $194.98 | $275.42 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $54.95 Typical High $79.43 | Professional | 55 · Aftercare only | $38.90 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $37.15 Typical High $52.48 | Professional | 56 · Pre-op care only | $26.30 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $257.04 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $181.97 | $257.04 | $371.54 |
Where Wyoming sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 3rd of 51
$724
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.