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 $194.98 Median $194.98 Typical High $218.78 | Facility | None | $194.98 | $194.98 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $389.05 | Professional | None | $194.98 | $218.78 | $389.05 |
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 $380.19 Median $575.44 Typical High $630.96 | Professional | None | $380.19 | $575.44 | $630.96 |
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 $257.04 Median $302.00 Typical High $467.74 | Professional | None | $257.04 | $302.00 | $467.74 |
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 $208.93 Median $380.19 Typical High $660.69 | Professional | None | $208.93 | $380.19 | $660.69 |
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 $97.72 Median $109.65 Typical High $194.98 | Professional | 52 · Reduced service | $97.72 | $109.65 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $43.65 Typical High $79.43 | Professional | 53 · Discontinued | $38.90 | $43.65 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $162.18 Typical High $295.12 | Professional | 54 · Surgery only | $147.91 | $162.18 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $32.36 Typical High $58.88 | Professional | 55 · Aftercare only | $29.51 | $32.36 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $21.88 Typical High $38.90 | Professional | 56 · Pre-op care only | $19.50 | $21.88 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $151.36 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $138.04 | $151.36 | $275.42 |
Where Wyoming sits
The same service costs 4.8 times more in Alaska than in Florida. 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
$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.