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 $575,439.94 Median $575,439.94 Typical High $575,439.94 | Facility | None | $575,439.94 | $575,439.94 | $575,439.94 |
Aetna Setting Professional Modifier None Typical Low $575,439.94 Median $575,439.94 Typical High $575,439.94 | Professional | None | $575,439.94 | $575,439.94 | $575,439.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114,815.36 Median $114,815.36 Typical High $114,815.36 | Professional | 53 · Discontinued | $114,815.36 | $114,815.36 | $114,815.36 |
BCBS Wyoming Setting Professional Modifier None Typical Low $575,439.94 Median $676,082.98 Typical High $676,082.98 | Professional | None | $575,439.94 | $676,082.98 | $676,082.98 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $398,107.17 Median $467,735.14 Typical High $467,735.14 | Professional | 53 · Discontinued | $398,107.17 | $467,735.14 | $467,735.14 |
United 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 |
3 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 $288,403.15 Median $288,403.15 Typical High $288,403.15 | Professional | 52 · Reduced service | $288,403.15 | $288,403.15 | $288,403.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87,096.36 Median $87,096.36 Typical High $87,096.36 | Professional | 55 · Aftercare only | $87,096.36 | $87,096.36 | $87,096.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57,543.99 Median $57,543.99 Typical High $57,543.99 | Professional | 56 · Pre-op care only | $57,543.99 | $57,543.99 | $57,543.99 |
Where Wyoming sits
The same service costs 1.7 times more in Texas than in Minnesota. 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· 5th of 51
$676,083
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.