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 $69.18 Median $69.18 Typical High $100.00 | Facility | None | $69.18 | $69.18 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $141.25 | Professional | None | $69.18 | $100.00 | $141.25 |
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 $134.90 Median $204.17 Typical High $295.12 | Professional | None | $134.90 | $204.17 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $186.21 Typical High $269.15 | Facility | None | $114.82 | $186.21 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $199.53 | Professional | None | $77.62 | $107.15 | $199.53 |
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 $85.11 Median $154.88 Typical High $263.03 | Professional | None | $85.11 | $154.88 | $263.03 |
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 $34.67 Median $50.12 Typical High $69.18 | Professional | 52 · Reduced service | $34.67 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $19.95 Typical High $28.18 | Professional | 53 · Discontinued | $14.13 | $19.95 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $74.13 Typical High $104.71 | Professional | 54 · Surgery only | $52.48 | $74.13 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $14.79 Typical High $20.89 | Professional | 55 · Aftercare only | $10.47 | $14.79 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.00 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.92 | $10.00 | $14.13 |
Where Wyoming sits
The same service costs 3.8 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· 3rd of 51
$195
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.