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 $229.09 Median $229.09 Typical High $309.03 | Facility | None | $229.09 | $229.09 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $309.03 | Professional | None | $229.09 | $281.84 | $309.03 |
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 $588.84 Median $912.01 Typical High $1,230.27 | Professional | None | $588.84 | $912.01 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,238.72 | Facility | None | $954.99 | $1,584.89 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $676.08 | Professional | None | $309.03 | $407.38 | $676.08 |
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 $309.03 Median $457.09 Typical High $891.25 | Professional | None | $309.03 | $457.09 | $891.25 |
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 $114.82 Median $141.25 Typical High $154.88 | Professional | 52 · Reduced service | $114.82 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $56.23 Typical High $61.66 | Professional | 53 · Discontinued | $45.71 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $213.80 Typical High $234.42 | Professional | 54 · Surgery only | $173.78 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $42.66 Typical High $46.77 | Professional | 55 · Aftercare only | $34.67 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.18 Typical High $30.90 | Professional | 56 · Pre-op care only | $22.91 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $199.53 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $162.18 | $199.53 | $218.78 |
Where Wyoming sits
The same service costs 4.3 times more in Alaska than in Utah. 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
$794
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.