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 $85.11 Median $85.11 Typical High $363.08 | Facility | None | $85.11 | $85.11 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $416.87 | Professional | None | $85.11 | $131.83 | $416.87 |
BCBS Wyoming Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
BCBS Wyoming Setting Professional Modifier None Typical Low $223.87 Median $416.87 Typical High $1,348.96 | Professional | None | $223.87 | $416.87 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $467.74 | Facility | None | $199.53 | $331.13 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $331.13 Typical High $660.69 | Professional | None | $114.82 | $331.13 | $660.69 |
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 $131.83 Median $331.13 Typical High $707.95 | Professional | None | $131.83 | $331.13 | $707.95 |
5 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 $42.66 Median $57.54 Typical High $181.97 | Professional | 52 · Reduced service | $42.66 | $57.54 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $22.91 Typical High $72.44 | Professional | 53 · Discontinued | $16.98 | $22.91 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $85.11 Typical High $275.42 | Professional | 54 · Surgery only | $64.57 | $85.11 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.98 Typical High $54.95 | Professional | 55 · Aftercare only | $12.88 | $16.98 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.48 Typical High $36.31 | Professional | 56 · Pre-op care only | $8.51 | $11.48 | $36.31 |
Where Wyoming sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 14th 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.