How much rates vary
Facilitymedian $1,660 · 10th to 90th $794 to $6,457Professionalmedian $1,380 · 10th to 90th $759 to $1,862
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $707.95 Median $891.25 Typical High $1,995.26 | Facility | None | $707.95 | $891.25 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,621.81 Typical High $1,862.09 | Professional | None | $758.58 | $1,621.81 | $1,862.09 |
BCBS Mississippi Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
BCBS Mississippi Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,737.80 Typical High $6,606.93 | Facility | None | $977.24 | $1,737.80 | $6,606.93 |
United Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,995.26 | Professional | None | $758.58 | $891.25 | $1,995.26 |
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 $380.19 Median $812.83 Typical High $912.01 | Professional | 52 · Reduced service | $380.19 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $323.59 Typical High $371.54 | Professional | 53 · Discontinued | $151.36 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $1,230.27 Typical High $1,380.38 | Professional | 54 · Surgery only | $575.44 | $1,230.27 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $245.47 Typical High $275.42 | Professional | 55 · Aftercare only | $114.82 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $162.18 Typical High $186.21 | Professional | 56 · Pre-op care only | $75.86 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $1,148.15 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $537.03 | $1,148.15 | $1,288.25 |
Where Mississippi sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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.
Physician feeFacility fee
WI $8,857KS $2,587
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.