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 $229.09 Median $229.09 Typical High $263.03 | Facility | None | $229.09 | $229.09 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $467.74 | Professional | None | $229.09 | $263.03 | $467.74 |
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 $457.09 Median $691.83 Typical High $776.25 | Professional | None | $457.09 | $691.83 | $776.25 |
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 $309.03 Median $363.08 Typical High $575.44 | Professional | None | $309.03 | $363.08 | $575.44 |
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 $281.84 Median $457.09 Typical High $794.33 | Professional | None | $281.84 | $457.09 | $794.33 |
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 $114.82 Median $131.83 Typical High $234.42 | Professional | 52 · Reduced service | $114.82 | $131.83 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $93.33 | Professional | 53 · Discontinued | $45.71 | $52.48 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $194.98 Typical High $346.74 | Professional | 54 · Surgery only | $173.78 | $194.98 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.90 Typical High $70.79 | Professional | 55 · Aftercare only | $34.67 | $38.90 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $46.77 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $181.97 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $162.18 | $181.97 | $323.59 |
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· 5th of 51
$513
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.