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 $151.36 Median $151.36 Typical High $181.97 | Facility | None | $151.36 | $151.36 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $309.03 | Professional | None | $151.36 | $181.97 | $309.03 |
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 $295.12 Median $446.68 Typical High $537.03 | Professional | None | $295.12 | $446.68 | $537.03 |
BCBS Wyoming Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $676.08 Typical High $812.83 | Professional | 50 · Both sides | $446.68 | $676.08 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $323.59 Typical High $457.09 | Facility | None | $194.98 | $323.59 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $407.38 | Professional | None | $204.17 | $251.19 | $407.38 |
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 $169.82 Median $302.00 Typical High $549.54 | Professional | None | $169.82 | $302.00 | $549.54 |
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 $75.86 Median $91.20 Typical High $151.36 | Professional | 52 · Reduced service | $75.86 | $91.20 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $36.31 Typical High $61.66 | Professional | 53 · Discontinued | $30.20 | $36.31 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $138.04 Typical High $229.09 | Professional | 54 · Surgery only | $114.82 | $138.04 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $27.54 Typical High $45.71 | Professional | 55 · Aftercare only | $22.91 | $27.54 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $18.20 Typical High $30.90 | Professional | 56 · Pre-op care only | $15.14 | $18.20 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $128.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $107.15 | $128.82 | $213.80 |
Where Wyoming sits
The same service costs 4.6 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· 4th of 51
$355
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.