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 $81.28 Median $81.28 Typical High $107.15 | Facility | None | $81.28 | $81.28 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $169.82 | Professional | None | $81.28 | $104.71 | $169.82 |
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 $154.88 Median $234.42 Typical High $302.00 | Professional | None | $154.88 | $234.42 | $302.00 |
BCBS Wyoming Setting Professional Modifier 50 · Both sides Typical Low $154.88 Median $302.00 Typical High $457.09 | Professional | 50 · Both sides | $154.88 | $302.00 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $147.91 Typical High $208.93 | Facility | None | $91.20 | $147.91 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $251.19 | Professional | None | $128.82 | $173.78 | $251.19 |
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 $109.65 Median $165.96 Typical High $338.84 | Professional | None | $109.65 | $165.96 | $338.84 |
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 $40.74 Median $51.29 Typical High $85.11 | Professional | 52 · Reduced service | $40.74 | $51.29 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $20.42 Typical High $33.88 | Professional | 53 · Discontinued | $16.22 | $20.42 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $77.62 Typical High $125.89 | Professional | 54 · Surgery only | $61.66 | $77.62 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.49 Typical High $25.12 | Professional | 55 · Aftercare only | $12.30 | $15.49 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.23 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.13 | $10.23 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $72.44 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $57.54 | $72.44 | $117.49 |
Where Wyoming sits
The same service costs 3.9 times more in Alaska than in Florida. 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
$204
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.