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 $269.15 Median $269.15 Typical High $371.54 | Facility | None | $269.15 | $269.15 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $371.54 | Professional | None | $269.15 | $338.84 | $371.54 |
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 $691.83 Median $1,071.52 Typical High $1,445.44 | Professional | None | $691.83 | $1,071.52 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $3,548.13 Typical High $5,011.87 | Facility | None | $2,137.96 | $3,548.13 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $794.33 | Professional | None | $371.54 | $501.19 | $794.33 |
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 $371.54 Median $537.03 Typical High $1,096.48 | Professional | None | $371.54 | $537.03 | $1,096.48 |
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 $134.90 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $134.90 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $67.61 Typical High $75.86 | Professional | 53 · Discontinued | $53.70 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $251.19 Typical High $281.84 | Professional | 54 · Surgery only | $204.17 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $50.12 Typical High $56.23 | Professional | 55 · Aftercare only | $40.74 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $26.92 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $234.42 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $190.55 | $234.42 | $263.03 |
Where Wyoming sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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
$955
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.