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 $295.12 Median $295.12 Typical High $309.03 | Facility | None | $295.12 | $295.12 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $588.84 | Professional | None | $295.12 | $309.03 | $588.84 |
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 $371.54 Median $426.58 Typical High $676.08 | Professional | None | $371.54 | $426.58 | $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 $288.40 Median $524.81 Typical High $912.01 | Professional | None | $288.40 | $524.81 | $912.01 |
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 $147.91 Median $154.88 Typical High $295.12 | Professional | 52 · Reduced service | $147.91 | $154.88 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $61.66 Typical High $117.49 | Professional | 53 · Discontinued | $58.88 | $61.66 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $234.42 Typical High $436.52 | Professional | 54 · Surgery only | $223.87 | $234.42 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $46.77 Typical High $89.13 | Professional | 55 · Aftercare only | $44.67 | $46.77 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.90 Typical High $58.88 | Professional | 56 · Pre-op care only | $29.51 | $30.90 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $218.78 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $208.93 | $218.78 | $407.38 |
Where Wyoming sits
The same service costs 5.6 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· 6th 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.