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 $181.97 Median $181.97 Typical High $269.15 | Facility | None | $181.97 | $181.97 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $269.15 | Professional | None | $181.97 | $245.47 | $269.15 |
BCBS Wyoming Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
BCBS Wyoming Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $1,047.13 | Professional | None | $467.74 | $724.44 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $707.95 Typical High $1,000.00 | Facility | None | $426.58 | $707.95 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $562.34 | Professional | None | $239.88 | $338.84 | $562.34 |
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 $257.04 Median $371.54 Typical High $707.95 | Professional | None | $257.04 | $371.54 | $707.95 |
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 $91.20 Median $123.03 Typical High $134.90 | Professional | 52 · Reduced service | $91.20 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $48.98 Typical High $53.70 | Professional | 53 · Discontinued | $36.31 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $181.97 Typical High $204.17 | Professional | 54 · Surgery only | $134.90 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $36.31 Typical High $40.74 | Professional | 55 · Aftercare only | $26.92 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $24.55 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.20 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $169.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $125.89 | $169.82 | $190.55 |
Where Wyoming sits
The same service costs 4.2 times more in Alaska than in Texas. 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
$575
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.