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 $208.93 Median $208.93 Typical High $223.87 | Facility | None | $208.93 | $208.93 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $416.87 | Professional | None | $204.17 | $223.87 | $416.87 |
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 $407.38 Median $616.60 Typical High $660.69 | Professional | None | $407.38 | $616.60 | $660.69 |
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 $275.42 Median $316.23 Typical High $478.63 | Professional | None | $275.42 | $316.23 | $478.63 |
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 $223.87 Median $389.05 Typical High $676.08 | Professional | None | $223.87 | $389.05 | $676.08 |
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 $104.71 Median $112.20 Typical High $208.93 | Professional | 52 · Reduced service | $104.71 | $112.20 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $85.11 | Professional | 53 · Discontinued | $41.69 | $44.67 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $165.96 Typical High $316.23 | Professional | 54 · Surgery only | $158.49 | $165.96 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.88 Typical High $63.10 | Professional | 55 · Aftercare only | $31.62 | $33.88 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.39 Typical High $41.69 | Professional | 56 · Pre-op care only | $20.89 | $22.39 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $154.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $147.91 | $154.88 | $295.12 |
Where Wyoming sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$437
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.