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 $47.86 Median $47.86 Typical High $134.90 | Facility | None | $47.86 | $47.86 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $70.79 Typical High $134.90 | Professional | None | $47.86 | $70.79 | $134.90 |
BCBS Wyoming Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
BCBS Wyoming Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $512.86 | Professional | None | $125.89 | $234.42 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $407.38 | Facility | None | $173.78 | $281.84 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $128.82 Typical High $245.47 | Professional | None | $74.13 | $128.82 | $245.47 |
United Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $3,162.28 | Facility | None | $501.19 | $794.33 | $3,162.28 |
United Setting Professional Modifier None Typical Low $74.13 Median $147.91 Typical High $275.42 | Professional | None | $74.13 | $147.91 | $275.42 |
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 $23.99 Median $33.11 Typical High $67.61 | Professional | 52 · Reduced service | $23.99 | $33.11 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $13.18 Typical High $26.92 | Professional | 53 · Discontinued | $9.55 | $13.18 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $48.98 Typical High $100.00 | Professional | 54 · Surgery only | $35.48 | $48.98 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.77 Typical High $19.95 | Professional | 55 · Aftercare only | $7.24 | $9.77 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.61 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.79 | $6.61 | $13.49 |
Where Wyoming sits
The same service costs 3.5 times more in Alaska 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· 4th of 51
$195
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.