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 $162.18 Median $162.18 Typical High $263.03 | Facility | None | $162.18 | $162.18 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $323.59 | Professional | None | $162.18 | $251.19 | $323.59 |
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 $489.78 Typical High $741.31 | Professional | None | $302.00 | $489.78 | $741.31 |
BCBS Wyoming Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $691.83 Typical High $1,122.02 | Professional | 50 · Both sides | $302.00 | $691.83 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $446.68 Typical High $630.96 | Facility | None | $275.42 | $446.68 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $575.44 | Professional | None | $223.87 | $338.84 | $575.44 |
United Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $3,162.28 | Facility | None | $501.19 | $794.33 | $3,162.28 |
United Setting Professional Modifier None Typical Low $223.87 Median $398.11 Typical High $707.95 | Professional | None | $223.87 | $398.11 | $707.95 |
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 $125.89 Typical High $162.18 | Professional | 52 · Reduced service | $79.43 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $50.12 Typical High $64.57 | Professional | 53 · Discontinued | $32.36 | $50.12 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $120.23 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $37.15 Typical High $48.98 | Professional | 55 · Aftercare only | $23.99 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $25.12 Typical High $32.36 | Professional | 56 · Pre-op care only | $16.22 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $173.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $112.20 | $173.78 | $229.09 |
Where Wyoming sits
The same service costs 3.5 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· 3rd 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.