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 $128.82 Median $128.82 Typical High $151.36 | Facility | None | $128.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $263.03 | Professional | None | $128.82 | $151.36 | $263.03 |
BCBS Wyoming Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
BCBS Wyoming Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $446.68 | Professional | None | $245.47 | $371.54 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $524.81 | Facility | None | $223.87 | $363.08 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $338.84 | Professional | None | $177.83 | $213.80 | $338.84 |
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 $257.04 Typical High $478.63 | Professional | None | $158.49 | $257.04 | $478.63 |
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 $63.10 Median $75.86 Typical High $131.83 | Professional | 52 · Reduced service | $63.10 | $75.86 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $30.90 Typical High $52.48 | Professional | 53 · Discontinued | $25.70 | $30.90 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $114.82 Typical High $194.98 | Professional | 54 · Surgery only | $95.50 | $114.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.91 Typical High $38.90 | Professional | 55 · Aftercare only | $19.05 | $22.91 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.14 Typical High $26.30 | Professional | 56 · Pre-op care only | $12.88 | $15.14 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $107.15 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $89.13 | $107.15 | $181.97 |
Where Wyoming sits
The same service costs 3.8 times more in Alaska than in Delaware. 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
$295
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.