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 $676.08 Median $676.08 Typical High $831.76 | Facility | None | $676.08 | $676.08 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,348.96 | Professional | None | $676.08 | $776.25 | $1,348.96 |
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 $1,202.26 Median $1,819.70 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,819.70 | $2,238.72 |
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 $851.14 Median $1,071.52 Typical High $1,698.24 | Professional | None | $851.14 | $1,071.52 | $1,698.24 |
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 $724.44 Median $1,288.25 Typical High $2,398.83 | Professional | None | $724.44 | $1,288.25 | $2,398.83 |
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 $331.13 Median $389.05 Typical High $676.08 | Professional | 52 · Reduced service | $331.13 | $389.05 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $154.88 Typical High $269.15 | Professional | 53 · Discontinued | $134.90 | $154.88 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $1,000.00 | Professional | 54 · Surgery only | $501.19 | $588.84 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $204.17 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $77.62 Typical High $134.90 | Professional | 56 · Pre-op care only | $67.61 | $77.62 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $933.25 |
Where Wyoming sits
The same service costs 6.6 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
$1,479
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.