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 $109.65 Median $109.65 Typical High $151.36 | Facility | None | $109.65 | $109.65 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $169.82 | Professional | None | $109.65 | $151.36 | $169.82 |
BCBS Wyoming Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
BCBS Wyoming Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $588.84 | Professional | None | $288.40 | $446.68 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $239.88 Typical High $338.84 | Facility | None | $144.54 | $239.88 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $323.59 | Professional | None | $147.91 | $204.17 | $323.59 |
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 $147.91 Median $213.80 Typical High $436.52 | Professional | None | $147.91 | $213.80 | $436.52 |
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 $54.95 Median $67.61 Typical High $75.86 | Professional | 52 · Reduced service | $54.95 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.92 Typical High $30.20 | Professional | 53 · Discontinued | $22.39 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $102.33 Typical High $112.20 | Professional | 54 · Surgery only | $83.18 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.42 Typical High $22.91 | Professional | 55 · Aftercare only | $16.60 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.49 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.96 | $13.49 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $95.50 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $77.62 | $95.50 | $104.71 |
Where Wyoming sits
The same service costs 4.0 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
$347
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.