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 $537.03 Median $537.03 Typical High $645.65 | Facility | None | $537.03 | $537.03 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $1,096.48 | Professional | None | $537.03 | $645.65 | $1,096.48 |
BCBS Wyoming Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
BCBS Wyoming Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,548.82 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $3,162.28 Median $5,128.61 Typical High $7,413.10 | Facility | None | $3,162.28 | $5,128.61 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,621.81 | Professional | None | $870.96 | $1,096.48 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $10,471.29 | Facility | None | $1,698.24 | $2,630.27 | $10,471.29 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $2,137.96 | Professional | None | $741.31 | $1,148.15 | $2,137.96 |
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 $269.15 Median $323.59 Typical High $549.54 | Professional | 52 · Reduced service | $269.15 | $323.59 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $128.82 Typical High $218.78 | Professional | 53 · Discontinued | $107.15 | $128.82 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $478.63 Typical High $831.76 | Professional | 54 · Surgery only | $407.38 | $478.63 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $97.72 Typical High $165.96 | Professional | 55 · Aftercare only | $81.28 | $97.72 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $64.57 Typical High $109.65 | Professional | 56 · Pre-op care only | $53.70 | $64.57 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $446.68 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $380.19 | $446.68 | $776.25 |
Where Wyoming sits
The same service costs 6.2 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· 6th of 51
$1,202
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.