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 $2,818.38 | Facility | None | $758.58 | $1,318.26 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $4,365.16 Typical High $9,120.11 | Professional | None | $1,949.84 | $4,365.16 | $9,120.11 |
BCBS Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
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 $1,412.54 Median $3,090.30 Typical High $3,388.44 | Professional | None | $1,412.54 | $3,090.30 | $3,388.44 |
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 $1,862.09 Median $2,187.76 Typical High $5,248.07 | Professional | None | $1,862.09 | $2,187.76 | $5,248.07 |
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 $977.24 Median $2,187.76 Typical High $4,570.88 | Professional | 52 · Reduced service | $977.24 | $2,187.76 | $4,570.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $870.96 Typical High $1,819.70 | Professional | 53 · Discontinued | $389.05 | $870.96 | $1,819.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $3,235.94 Typical High $6,760.83 | Professional | 54 · Surgery only | $1,479.11 | $3,235.94 | $6,760.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $645.65 Typical High $1,348.96 | Professional | 55 · Aftercare only | $295.12 | $645.65 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $436.52 Typical High $912.01 | Professional | 56 · Pre-op care only | $194.98 | $436.52 | $912.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $3,019.95 Typical High $6,309.57 | Professional | 78 · Unplanned return to OR | $1,380.38 | $3,019.95 | $6,309.57 |
Where Mississippi sits
The same service costs 6.0 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· 40th of 51
$2,138
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.