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 $158.49 Median $158.49 Typical High $275.42 | Facility | None | $158.49 | $158.49 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $316.23 | Professional | None | $158.49 | $257.04 | $316.23 |
BCBS Wyoming Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
BCBS Wyoming Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $776.25 | Professional | None | $302.00 | $512.86 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $2,511.89 | Facility | None | $1,071.52 | $1,778.28 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $575.44 | Professional | None | $213.80 | $354.81 | $575.44 |
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 $218.78 Median $389.05 Typical High $724.44 | Professional | None | $218.78 | $389.05 | $724.44 |
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 $79.43 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $79.43 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $52.48 Typical High $64.57 | Professional | 53 · Discontinued | $31.62 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $194.98 Typical High $239.88 | Professional | 54 · Surgery only | $117.49 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $38.90 Typical High $47.86 | Professional | 55 · Aftercare only | $23.44 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $25.70 Typical High $31.62 | Professional | 56 · Pre-op care only | $15.85 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $181.97 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $109.65 | $181.97 | $223.87 |
Where Wyoming sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$457
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.