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 $158.49 Median $158.49 Typical High $275.42 | Facility | None | $158.49 | $158.49 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $323.59 | Professional | None | $158.49 | $275.42 | $323.59 |
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 $309.03 Median $549.54 Typical High $831.76 | Professional | None | $309.03 | $549.54 | $831.76 |
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 $194.98 Median $302.00 Typical High $549.54 | Professional | None | $194.98 | $302.00 | $549.54 |
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 $213.80 Median $398.11 Typical High $676.08 | Professional | None | $213.80 | $398.11 | $676.08 |
5 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 $79.43 Median $134.90 Typical High $158.49 | Professional | 52 · Reduced service | $79.43 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $54.95 Typical High $64.57 | Professional | 53 · Discontinued | $31.62 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $204.17 Typical High $239.88 | Professional | 54 · Surgery only | $120.23 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $40.74 Typical High $47.86 | Professional | 55 · Aftercare only | $23.99 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $27.54 Typical High $32.36 | Professional | 56 · Pre-op care only | $15.85 | $27.54 | $32.36 |
Where Wyoming sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 3rd of 51
$468
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.