How much rates vary
Facilitymedian $1,585 · 10th to 90th $692 to $5,623Professionalmedian $1,072 · 10th to 90th $575 to $1,660
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 $588.84 Median $891.25 Typical High $1,819.70 | Facility | None | $588.84 | $891.25 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $1,288.25 Typical High $1,445.44 | Professional | None | $588.84 | $1,288.25 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,548.82 Typical High $3,162.28 | Facility | None | $630.96 | $1,548.82 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $1,096.48 Typical High $1,318.26 | Professional | None | $478.63 | $1,096.48 | $1,318.26 |
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 $602.56 Median $691.83 Typical High $1,584.89 | Professional | None | $602.56 | $691.83 | $1,584.89 |
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 $295.12 Median $630.96 Typical High $724.44 | Professional | 52 · Reduced service | $295.12 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $257.04 Typical High $288.40 | Professional | 53 · Discontinued | $120.23 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $954.99 Typical High $1,071.52 | Professional | 54 · Surgery only | $446.68 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $190.55 Typical High $213.80 | Professional | 55 · Aftercare only | $89.13 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $128.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $58.88 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $891.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $416.87 | $891.25 | $1,000.00 |
Where Mississippi sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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 $7,283HI $2,091
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.