How much rates vary
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 $1,318.26 Typical High $5,011.87 | Facility | None | $758.58 | $1,318.26 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $5,011.87 Median $12,302.69 Typical High $12,302.69 | Professional | None | $5,011.87 | $12,302.69 | $12,302.69 |
BCBS Mississippi Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,309.57 | $6,309.57 | $6,309.57 |
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 $323.59 Median $691.83 Typical High $3,090.30 | Facility | None | $323.59 | $691.83 | $3,090.30 |
United Setting Professional Modifier None Typical Low $3,890.45 Median $5,128.61 Typical High $11,748.98 | Professional | None | $3,890.45 | $5,128.61 | $11,748.98 |
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 $2,454.71 Median $6,165.95 Typical High $6,165.95 | Professional | 52 · Reduced service | $2,454.71 | $6,165.95 | $6,165.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $2,454.71 Typical High $2,454.71 | Professional | 53 · Discontinued | $1,000.00 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,715.35 Median $9,120.11 Typical High $9,120.11 | Professional | 54 · Surgery only | $3,715.35 | $9,120.11 | $9,120.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $741.31 Median $1,819.70 Typical High $1,819.70 | Professional | 55 · Aftercare only | $741.31 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $501.19 Median $1,230.27 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $501.19 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,467.37 Median $8,511.38 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $3,467.37 | $8,511.38 | $8,511.38 |
Where Mississippi sits
The same service costs 22.9 times more in Alaska than in Texas. 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.
Mississippi· 32nd of 51
$5,012
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.