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 $630.96 Median $630.96 Typical High $831.76 | Facility | None | $630.96 | $630.96 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,288.25 | Professional | None | $630.96 | $794.33 | $1,288.25 |
BCBS Wyoming Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Facility | None | $6,309.57 | $6,309.57 | $6,309.57 |
BCBS Wyoming Setting Professional Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,174.90 | $1,778.28 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $4,466.84 Median $7,244.36 Typical High $10,232.93 | Facility | None | $4,466.84 | $7,244.36 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,778.28 | Professional | None | $831.76 | $1,096.48 | $1,778.28 |
United Setting Facility Modifier None Typical Low $2,951.21 Median $5,128.61 Typical High $17,782.79 | Facility | None | $2,951.21 | $5,128.61 | $17,782.79 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,288.25 Typical High $2,511.89 | Professional | None | $831.76 | $1,288.25 | $2,511.89 |
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 $316.23 Median $398.11 Typical High $630.96 | Professional | 52 · Reduced service | $316.23 | $398.11 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $158.49 Typical High $257.04 | Professional | 53 · Discontinued | $125.89 | $158.49 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $588.84 Typical High $954.99 | Professional | 54 · Surgery only | $467.74 | $588.84 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $117.49 Typical High $190.55 | Professional | 55 · Aftercare only | $93.33 | $117.49 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $79.43 Typical High $128.82 | Professional | 56 · Pre-op care only | $63.10 | $79.43 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $549.54 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $436.52 | $549.54 | $891.25 |
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· 4th of 51
$1,514
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.