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 $501.19 Median $501.19 Typical High $537.03 | Facility | None | $501.19 | $501.19 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $1,000.00 | Professional | None | $501.19 | $537.03 | $1,000.00 |
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 $954.99 Median $1,445.44 Typical High $1,548.82 | Professional | None | $954.99 | $1,445.44 | $1,548.82 |
BCBS Wyoming Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,548.82 Typical High $2,344.23 | Professional | 50 · Both sides | $954.99 | $1,548.82 | $2,344.23 |
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 $645.65 Median $741.31 Typical High $1,122.02 | Professional | None | $645.65 | $741.31 | $1,122.02 |
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 $524.81 Median $912.01 Typical High $1,584.89 | Professional | None | $524.81 | $912.01 | $1,584.89 |
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 $245.47 Median $263.03 Typical High $489.78 | Professional | 52 · Reduced service | $245.47 | $263.03 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $107.15 Typical High $199.53 | Professional | 53 · Discontinued | $100.00 | $107.15 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $741.31 | Professional | 54 · Surgery only | $371.54 | $398.11 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $147.91 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $53.70 Typical High $100.00 | Professional | 56 · Pre-op care only | $50.12 | $53.70 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $691.83 |
Where Wyoming sits
The same service costs 5.8 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
$1,023
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.