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 $302.00 Median $302.00 Typical High $316.23 | Facility | None | $302.00 | $302.00 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $316.23 Typical High $602.56 | Professional | None | $302.00 | $316.23 | $602.56 |
BCBS Wyoming Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
BCBS Wyoming Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $912.01 | Professional | None | $575.44 | $870.96 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $323.59 Typical High $457.09 | Facility | None | $199.53 | $323.59 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $676.08 | Professional | None | $389.05 | $436.52 | $676.08 |
United Setting Facility Modifier None Typical Low $223.87 Median $295.12 Typical High $3,090.30 | Facility | None | $223.87 | $295.12 | $3,090.30 |
United Setting Professional Modifier None Typical Low $309.03 Median $537.03 Typical High $933.25 | Professional | None | $309.03 | $537.03 | $933.25 |
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 $151.36 Median $158.49 Typical High $302.00 | Professional | 52 · Reduced service | $151.36 | $158.49 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $63.10 Typical High $120.23 | Professional | 53 · Discontinued | $60.26 | $63.10 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $239.88 Typical High $446.68 | Professional | 54 · Surgery only | $223.87 | $239.88 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $91.20 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $31.62 Typical High $60.26 | Professional | 56 · Pre-op care only | $30.20 | $31.62 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $223.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $208.93 | $223.87 | $416.87 |
Where Wyoming sits
The same service costs 5.5 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· 7th of 51
$603
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.