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 $616.60 Median $616.60 Typical High $741.31 | Facility | None | $616.60 | $616.60 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,230.27 | Professional | None | $616.60 | $724.44 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $245.47 | Professional | 53 · Discontinued | $123.03 | $144.54 | $245.47 |
BCBS Wyoming Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
BCBS Wyoming Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,698.24 | $2,041.74 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $1,202.26 Typical High $1,445.44 | Professional | 53 · Discontinued | $794.33 | $1,202.26 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,238.72 | Facility | None | $954.99 | $1,584.89 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,548.82 | Professional | None | $831.76 | $1,000.00 | $1,548.82 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,288.25 Typical High $5,370.32 | Facility | None | $660.69 | $1,288.25 | $5,370.32 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,148.15 Typical High $2,137.96 | Professional | None | $676.08 | $1,148.15 | $2,137.96 |
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 $309.03 Median $363.08 Typical High $616.60 | Professional | 52 · Reduced service | $309.03 | $363.08 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $912.01 | Professional | 54 · Surgery only | $457.09 | $537.03 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $181.97 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $123.03 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $426.58 | $501.19 | $851.14 |
Where Wyoming sits
The same service costs 5.6 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
$1,349
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.