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 $52.48 Median $501.19 Typical High $501.19 | Facility | None | $52.48 | $501.19 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $125.89 | Professional | None | $52.48 | $74.13 | $125.89 |
BCBS Wyoming Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
BCBS Wyoming Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $245.47 | Professional | None | $107.15 | $169.82 | $245.47 |
BCBS Wyoming Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $229.09 Typical High $371.54 | Professional | 50 · Both sides | $107.15 | $229.09 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $97.72 Typical High $141.25 | Facility | None | $60.26 | $97.72 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $204.17 | Professional | None | $87.10 | $123.03 | $204.17 |
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 $87.10 Median $120.23 Typical High $316.23 | Professional | None | $87.10 | $120.23 | $316.23 |
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 $26.30 Median $37.15 Typical High $63.10 | Professional | 52 · Reduced service | $26.30 | $37.15 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $14.79 Typical High $25.12 | Professional | 53 · Discontinued | $10.47 | $14.79 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $54.95 Typical High $95.50 | Professional | 54 · Surgery only | $39.81 | $54.95 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.96 Typical High $19.05 | Professional | 55 · Aftercare only | $7.94 | $10.96 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.41 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.25 | $7.41 | $12.59 |
Where Wyoming sits
The same service costs 3.2 times more in Alaska than in Texas. 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
$151
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.