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 $144.54 Median $144.54 Typical High $363.08 | Facility | None | $144.54 | $144.54 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $288.40 Typical High $371.54 | Professional | None | $144.54 | $288.40 | $371.54 |
BCBS Wyoming Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
BCBS Wyoming Setting Professional Modifier None Typical Low $275.42 Median $501.19 Typical High $1,000.00 | Professional | None | $275.42 | $501.19 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $371.54 | Facility | None | $162.18 | $263.03 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $616.60 | Professional | None | $186.21 | $316.23 | $616.60 |
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 $194.98 Median $380.19 Typical High $691.83 | Professional | None | $194.98 | $380.19 | $691.83 |
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 $70.79 Median $144.54 Typical High $186.21 | Professional | 52 · Reduced service | $70.79 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $57.54 Typical High $74.13 | Professional | 53 · Discontinued | $28.84 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $213.80 Typical High $275.42 | Professional | 54 · Surgery only | $107.15 | $213.80 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $42.66 Typical High $54.95 | Professional | 55 · Aftercare only | $21.38 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $28.84 Typical High $37.15 | Professional | 56 · Pre-op care only | $14.45 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $199.53 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $100.00 | $199.53 | $257.04 |
Where Wyoming sits
The same service costs 3.6 times more in Wisconsin 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· 5th of 51
$417
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.