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 $123.03 Median $338.84 Typical High $338.84 | Facility | None | $123.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $251.19 | Professional | None | $123.03 | $151.36 | $251.19 |
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 $245.47 Median $398.11 Typical High $501.19 | Professional | None | $245.47 | $398.11 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $181.97 Typical High $263.03 | Facility | None | $112.20 | $181.97 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $331.13 | Professional | None | $177.83 | $204.17 | $331.13 |
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 $173.78 Median $251.19 Typical High $489.78 | Professional | None | $173.78 | $251.19 | $489.78 |
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 $61.66 Median $75.86 Typical High $144.54 | Professional | 52 · Reduced service | $61.66 | $75.86 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $30.20 Typical High $57.54 | Professional | 53 · Discontinued | $24.55 | $30.20 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $112.20 Typical High $213.80 | Professional | 54 · Surgery only | $91.20 | $112.20 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.39 Typical High $42.66 | Professional | 55 · Aftercare only | $18.20 | $22.39 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.14 Typical High $28.84 | Professional | 56 · Pre-op care only | $12.30 | $15.14 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $104.71 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $85.11 | $104.71 | $199.53 |
Where Wyoming sits
The same service costs 3.9 times more in Alaska than in Florida. 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
$309
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.