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 $158.49 Median $158.49 Typical High $245.47 | Facility | None | $158.49 | $158.49 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $389.05 | Professional | None | $154.88 | $234.42 | $389.05 |
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 $309.03 Median $501.19 Typical High $776.25 | Professional | None | $309.03 | $501.19 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,148.15 Typical High $1,659.59 | Facility | None | $707.95 | $1,148.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $562.34 | Professional | None | $208.93 | $316.23 | $562.34 |
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 $223.87 Median $363.08 Typical High $831.76 | Professional | None | $223.87 | $363.08 | $831.76 |
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 $77.62 Median $114.82 Typical High $194.98 | Professional | 52 · Reduced service | $77.62 | $114.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $46.77 Typical High $77.62 | Professional | 53 · Discontinued | $30.90 | $46.77 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $173.78 Typical High $295.12 | Professional | 54 · Surgery only | $117.49 | $173.78 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $34.67 Typical High $58.88 | Professional | 55 · Aftercare only | $23.44 | $34.67 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $23.44 Typical High $38.90 | Professional | 56 · Pre-op care only | $15.49 | $23.44 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $162.18 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $109.65 | $162.18 | $275.42 |
Where Wyoming sits
The same service costs 4.2 times more in Alaska than in Virginia. 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
$479
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.