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 $83.18 Median $1,071.52 Typical High $1,071.52 | Facility | None | $83.18 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $151.36 Typical High $218.78 | Professional | None | $83.18 | $151.36 | $218.78 |
BCBS Wyoming Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
BCBS Wyoming Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $478.63 | Professional | None | $158.49 | $288.40 | $478.63 |
BCBS Wyoming Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $354.81 Typical High $707.95 | Professional | 50 · Both sides | $158.49 | $354.81 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $354.81 | Professional | None | $114.82 | $208.93 | $354.81 |
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 $117.49 Median $213.80 Typical High $512.86 | Professional | None | $117.49 | $213.80 | $512.86 |
5 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 $41.69 Median $81.28 Typical High $85.11 | Professional | 52 · Reduced service | $41.69 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $32.36 Typical High $34.67 | Professional | 53 · Discontinued | $16.60 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $120.23 Typical High $128.82 | Professional | 54 · Surgery only | $61.66 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $23.99 Typical High $25.70 | Professional | 55 · Aftercare only | $12.30 | $23.99 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $16.22 Typical High $17.38 | Professional | 56 · Pre-op care only | $8.32 | $16.22 | $17.38 |
Where Wyoming sits
The same service costs 3.9 times more in Alaska than in Virginia. 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
$240
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.