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 $165.96 Median $165.96 Typical High $239.88 | Facility | None | $165.96 | $165.96 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $269.15 | Professional | None | $165.96 | $229.09 | $269.15 |
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 $436.52 Median $676.08 Typical High $954.99 | Professional | None | $436.52 | $676.08 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $524.81 | Facility | None | $223.87 | $363.08 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $512.86 | Professional | None | $229.09 | $316.23 | $512.86 |
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 $239.88 Median $338.84 Typical High $660.69 | Professional | None | $239.88 | $338.84 | $660.69 |
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 $83.18 Median $109.65 Typical High $120.23 | Professional | 52 · Reduced service | $83.18 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $43.65 Typical High $47.86 | Professional | 53 · Discontinued | $33.11 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $162.18 Typical High $177.83 | Professional | 54 · Surgery only | $125.89 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $25.12 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $21.88 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.60 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $151.36 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $117.49 | $151.36 | $165.96 |
Where Wyoming sits
The same service costs 3.8 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
$525
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.