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 $489.78 Median $489.78 Typical High $676.08 | Facility | None | $489.78 | $489.78 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $1,000.00 | Professional | None | $489.78 | $676.08 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $134.90 Typical High $204.17 | Professional | 53 · Discontinued | $97.72 | $134.90 | $204.17 |
BCBS Wyoming Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
BCBS Wyoming Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $1,949.84 | Professional | None | $933.25 | $1,412.54 | $1,949.84 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $977.24 Typical High $1,380.38 | Professional | 53 · Discontinued | $645.65 | $977.24 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $309.03 Typical High $436.52 | Facility | None | $190.55 | $309.03 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,548.82 | Professional | None | $794.33 | $1,047.13 | $1,548.82 |
United Setting Facility Modifier None Typical Low $223.87 Median $295.12 Typical High $3,090.30 | Facility | None | $223.87 | $295.12 | $3,090.30 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,174.90 Typical High $2,187.76 | Professional | None | $724.44 | $1,174.90 | $2,187.76 |
5 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 $245.47 Median $338.84 Typical High $501.19 | Professional | 52 · Reduced service | $245.47 | $338.84 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $512.86 Typical High $758.58 | Professional | 54 · Surgery only | $363.08 | $512.86 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $102.33 Typical High $151.36 | Professional | 55 · Aftercare only | $72.44 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $67.61 Typical High $100.00 | Professional | 56 · Pre-op care only | $48.98 | $67.61 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $478.63 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $338.84 | $478.63 | $707.95 |
Where Wyoming sits
The same service costs 3.6 times more in Alaska than in Maryland. 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
$1,318
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.