How much rates vary
Facilitymedian $2,692 · 10th to 90th $955 to $8,710Professionalmedian $1,202 · 10th to 90th $661 to $1,622
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 $758.58 Median $1,047.13 Typical High $1,995.26 | Facility | None | $758.58 | $1,047.13 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $1,445.44 Typical High $1,621.81 | Professional | None | $676.08 | $1,445.44 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
BCBS Mississippi Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
BCBS Mississippi Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $6,606.93 | Facility | None | $794.33 | $3,467.37 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $1,202.26 Typical High $1,288.25 | Professional | None | $549.54 | $1,202.26 | $1,288.25 |
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 $1,122.02 Median $2,511.89 Typical High $12,022.64 | Facility | None | $1,122.02 | $2,511.89 | $12,022.64 |
United Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,778.28 | Professional | None | $676.08 | $758.58 | $1,778.28 |
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 $338.84 Median $724.44 Typical High $812.83 | Professional | 52 · Reduced service | $338.84 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $288.40 Typical High $323.59 | Professional | 53 · Discontinued | $134.90 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $1,071.52 Typical High $1,230.27 | Professional | 54 · Surgery only | $501.19 | $1,071.52 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $213.80 Typical High $245.47 | Professional | 55 · Aftercare only | $100.00 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $144.54 Typical High $162.18 | Professional | 56 · Pre-op care only | $67.61 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $1,000.00 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $467.74 | $1,000.00 | $1,148.15 |
Where Mississippi sits
The same service costs 5.7 times more in Colorado than in Montana. 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
CO $13,613MT $2,377
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.