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 $489.78 Median $489.78 Typical High $660.69 | Facility | None | $489.78 | $489.78 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $1,023.29 | Professional | None | $489.78 | $645.65 | $1,023.29 |
BCBS Wyoming Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
BCBS Wyoming Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $1,905.46 | Professional | None | $933.25 | $1,412.54 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $3,890.45 Typical High $5,623.41 | Facility | None | $2,398.83 | $3,890.45 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,479.11 | Professional | None | $660.69 | $912.01 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $10,471.29 | Facility | None | $1,698.24 | $2,630.27 | $10,471.29 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,071.52 Typical High $1,905.46 | Professional | None | $660.69 | $1,071.52 | $1,905.46 |
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 $323.59 Typical High $512.86 | Professional | 52 · Reduced service | $245.47 | $323.59 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $131.83 Typical High $204.17 | Professional | 53 · Discontinued | $97.72 | $131.83 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $489.78 Typical High $758.58 | Professional | 54 · Surgery only | $371.54 | $489.78 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $97.72 Typical High $151.36 | Professional | 55 · Aftercare only | $74.13 | $97.72 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $64.57 Typical High $102.33 | Professional | 56 · Pre-op care only | $48.98 | $64.57 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $457.09 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $346.74 | $457.09 | $707.95 |
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· 3rd of 51
$1,259
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.