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 $44.67 Median $44.67 Typical High $83.18 | Facility | None | $44.67 | $44.67 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $109.65 | Professional | None | $44.67 | $79.43 | $109.65 |
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 $89.13 Median $162.18 Typical High $263.03 | Professional | None | $89.13 | $162.18 | $263.03 |
BCBS Wyoming Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $218.78 Typical High $398.11 | Professional | 50 · Both sides | $89.13 | $218.78 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $123.03 Typical High $177.83 | Facility | None | $75.86 | $123.03 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $208.93 | Professional | None | $75.86 | $141.25 | $208.93 |
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 $75.86 Median $117.49 Typical High $309.03 | Professional | None | $75.86 | $117.49 | $309.03 |
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 $22.39 Median $39.81 Typical High $54.95 | Professional | 52 · Reduced service | $22.39 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $15.85 Typical High $21.88 | Professional | 53 · Discontinued | $8.91 | $15.85 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $58.88 Typical High $81.28 | Professional | 54 · Surgery only | $33.88 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $11.75 Typical High $16.22 | Professional | 55 · Aftercare only | $6.76 | $11.75 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.94 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.47 | $7.94 | $10.96 |
Where Wyoming sits
The same service costs 3.0 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
$145
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.