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 $562,341.33 Median $562,341.33 Typical High $562,341.33 | Facility | None | $562,341.33 | $562,341.33 | $562,341.33 |
Aetna Setting Professional Modifier None Typical Low $562,341.33 Median $562,341.33 Typical High $562,341.33 | Professional | None | $562,341.33 | $562,341.33 | $562,341.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112,201.85 Median $112,201.85 Typical High $112,201.85 | Professional | 53 · Discontinued | $112,201.85 | $112,201.85 | $112,201.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85,113.80 Median $85,113.80 Typical High $85,113.80 | Professional | 55 · Aftercare only | $85,113.80 | $85,113.80 | $85,113.80 |
BCBS Wyoming Setting Professional Modifier None Typical Low $562,341.33 Median $660,693.45 Typical High $660,693.45 | Professional | None | $562,341.33 | $660,693.45 | $660,693.45 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $389,045.14 Median $457,088.19 Typical High $457,088.19 | Professional | 53 · Discontinued | $389,045.14 | $457,088.19 | $457,088.19 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $112,201.85 Median $131,825.67 Typical High $131,825.67 | Professional | 55 · Aftercare only | $112,201.85 | $131,825.67 | $131,825.67 |
United Setting Professional Modifier None Typical Low $537,031.80 Median $537,031.80 Typical High $537,031.80 | Professional | None | $537,031.80 | $537,031.80 | $537,031.80 |
2 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 $281,838.29 Median $281,838.29 Typical High $281,838.29 | Professional | 52 · Reduced service | $281,838.29 | $281,838.29 | $281,838.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56,234.13 Median $56,234.13 Typical High $56,234.13 | Professional | 56 · Pre-op care only | $56,234.13 | $56,234.13 | $56,234.13 |
Where Wyoming sits
Rates are fairly even across states for this service. 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
$660,693
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.