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 $131.83 Median $131.83 Typical High $239.88 | Facility | None | $131.83 | $131.83 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $245.47 | Professional | None | $131.83 | $199.53 | $245.47 |
BCBS Wyoming Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
BCBS Wyoming Setting Professional Modifier None Typical Low $338.84 Median $602.56 Typical High $933.25 | Professional | None | $338.84 | $602.56 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $407.38 Typical High $575.44 | Facility | None | $245.47 | $407.38 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $478.63 | Professional | None | $181.97 | $288.40 | $478.63 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,288.25 Typical High $5,370.32 | Facility | None | $660.69 | $1,288.25 | $5,370.32 |
United Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $588.84 | Professional | None | $190.55 | $295.12 | $588.84 |
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 $66.07 Median $91.20 Typical High $120.23 | Professional | 52 · Reduced service | $66.07 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $36.31 Typical High $47.86 | Professional | 53 · Discontinued | $26.30 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $138.04 Typical High $177.83 | Professional | 54 · Surgery only | $97.72 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $27.54 Typical High $35.48 | Professional | 55 · Aftercare only | $19.95 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $18.20 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.18 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $128.82 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $91.20 | $128.82 | $165.96 |
Where Wyoming sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 2nd 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.