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 $3,235.94 | Facility | None | $758.58 | $1,318.26 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $3,235.94 Median $7,079.46 Typical High $14,791.08 | Professional | None | $3,235.94 | $7,079.46 | $14,791.08 |
BCBS Mississippi Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,202.26 | Facility | None | $660.69 | $1,000.00 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $5,011.87 Typical High $5,495.41 | Professional | None | $2,290.87 | $5,011.87 | $5,495.41 |
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 $2,951.21 Median $3,630.78 Typical High $8,511.38 | Professional | None | $2,951.21 | $3,630.78 | $8,511.38 |
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 $1,584.89 Median $3,548.13 Typical High $7,413.10 | Professional | 52 · Reduced service | $1,584.89 | $3,548.13 | $7,413.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $1,412.54 Typical High $2,951.21 | Professional | 53 · Discontinued | $645.65 | $1,412.54 | $2,951.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $5,370.32 Typical High $11,220.18 | Professional | 54 · Surgery only | $2,398.83 | $5,370.32 | $11,220.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $1,071.52 Typical High $2,238.72 | Professional | 55 · Aftercare only | $478.63 | $1,071.52 | $2,238.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $707.95 Typical High $1,479.11 | Professional | 56 · Pre-op care only | $323.59 | $707.95 | $1,479.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $5,011.87 Typical High $10,471.29 | Professional | 78 · Unplanned return to OR | $2,238.72 | $5,011.87 | $10,471.29 |
Where Mississippi sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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· 42nd of 51
$3,236
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.