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 $186.21 Median $186.21 Typical High $316.23 | Facility | None | $186.21 | $186.21 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $371.54 | Professional | None | $186.21 | $316.23 | $371.54 |
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 $363.08 Median $630.96 Typical High $954.99 | Professional | None | $363.08 | $630.96 | $954.99 |
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 $204.17 Median $316.23 Typical High $630.96 | Professional | None | $204.17 | $316.23 | $630.96 |
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 $263.03 Median $426.58 Typical High $776.25 | Professional | None | $263.03 | $426.58 | $776.25 |
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 $93.33 Median $158.49 Typical High $186.21 | Professional | 52 · Reduced service | $93.33 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $37.15 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $234.42 Typical High $281.84 | Professional | 54 · Surgery only | $141.25 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $46.77 Typical High $56.23 | Professional | 55 · Aftercare only | $28.18 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $31.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $18.62 | $31.62 | $37.15 |
Where Wyoming sits
The same service costs 3.8 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
$550
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.