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 $144.54 Median $144.54 Typical High $165.96 | Facility | None | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $295.12 | Professional | None | $144.54 | $165.96 | $295.12 |
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 $281.84 Median $426.58 Typical High $489.78 | Professional | None | $281.84 | $426.58 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $398.11 | Facility | None | $173.78 | $281.84 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $363.08 | Professional | None | $194.98 | $229.09 | $363.08 |
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 $158.49 Median $288.40 Typical High $501.19 | Professional | None | $158.49 | $288.40 | $501.19 |
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 $72.44 Median $83.18 Typical High $147.91 | Professional | 52 · Reduced service | $72.44 | $83.18 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.11 Typical High $58.88 | Professional | 53 · Discontinued | $28.84 | $33.11 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $125.89 Typical High $218.78 | Professional | 54 · Surgery only | $109.65 | $125.89 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.12 Typical High $43.65 | Professional | 55 · Aftercare only | $21.88 | $25.12 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $29.51 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $117.49 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $102.33 | $117.49 | $204.17 |
Where Wyoming sits
The same service costs 4.9 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
$324
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.