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 $676.08 Median $676.08 Typical High $870.96 | Facility | None | $676.08 | $676.08 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $870.96 | Professional | None | $676.08 | $794.33 | $870.96 |
BCBS Wyoming Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Facility | None | $6,309.57 | $6,309.57 | $6,309.57 |
BCBS Wyoming Setting Professional Modifier None Typical Low $1,778.28 Median $2,691.53 Typical High $3,467.37 | Professional | None | $1,778.28 | $2,691.53 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $4,466.84 Median $7,244.36 Typical High $10,232.93 | Facility | None | $4,466.84 | $7,244.36 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,905.46 | Professional | None | $912.01 | $1,174.90 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $10,471.29 | Facility | None | $1,698.24 | $2,630.27 | $10,471.29 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $2,630.27 | Professional | None | $870.96 | $1,318.26 | $2,630.27 |
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 $338.84 Median $398.11 Typical High $436.52 | Professional | 52 · Reduced service | $338.84 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $134.90 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $512.86 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $102.33 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $79.43 Typical High $87.10 | Professional | 56 · Pre-op care only | $67.61 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $478.63 | $549.54 | $616.60 |
Where Wyoming sits
The same service costs 4.4 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
$2,239
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.