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 $138.04 Median $138.04 Typical High $245.47 | Facility | None | $138.04 | $138.04 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $263.03 | Professional | None | $138.04 | $218.78 | $263.03 |
BCBS Wyoming Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
BCBS Wyoming Setting Professional Modifier None Typical Low $363.08 Median $630.96 Typical High $977.24 | Professional | None | $363.08 | $630.96 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $478.63 Typical High $676.08 | Facility | None | $288.40 | $478.63 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $501.19 | Professional | None | $186.21 | $302.00 | $501.19 |
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 $199.53 Median $316.23 Typical High $630.96 | Professional | None | $199.53 | $316.23 | $630.96 |
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 $69.18 Median $95.50 Typical High $123.03 | Professional | 52 · Reduced service | $69.18 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.02 Typical High $48.98 | Professional | 53 · Discontinued | $27.54 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $141.25 Typical High $186.21 | Professional | 54 · Surgery only | $104.71 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.18 Typical High $37.15 | Professional | 55 · Aftercare only | $20.89 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.05 Typical High $24.55 | Professional | 56 · Pre-op care only | $13.80 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $131.83 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $97.72 | $131.83 | $173.78 |
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· 3rd of 51
$437
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.