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 $40.74 Median $40.74 Typical High $169.82 | Facility | None | $40.74 | $40.74 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $54.95 Typical High $169.82 | Professional | None | $40.74 | $54.95 | $169.82 |
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 $107.15 Median $194.98 Typical High $645.65 | Professional | None | $107.15 | $194.98 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $144.54 Typical High $316.23 | Professional | None | $54.95 | $144.54 | $316.23 |
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 $58.88 Median $154.88 Typical High $331.13 | Professional | None | $58.88 | $154.88 | $331.13 |
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 $20.42 Median $27.54 Typical High $85.11 | Professional | 52 · Reduced service | $20.42 | $27.54 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $10.96 Typical High $33.88 | Professional | 53 · Discontinued | $8.13 | $10.96 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $41.69 Typical High $128.82 | Professional | 54 · Surgery only | $30.20 | $41.69 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $8.32 Typical High $25.70 | Professional | 55 · Aftercare only | $6.03 | $8.32 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.50 Typical High $16.98 | Professional | 56 · Pre-op care only | $4.07 | $5.50 | $16.98 |
Where Wyoming sits
The same service costs 4.6 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· 11th of 51
$170
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.