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 $4,786.30 | Facility | None | $758.58 | $1,318.26 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $4,786.30 Median $10,715.19 Typical High $22,387.21 | Professional | None | $4,786.30 | $10,715.19 | $22,387.21 |
BCBS Mississippi Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
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 $4,168.69 Median $5,128.61 Typical High $12,302.69 | Professional | None | $4,168.69 | $5,128.61 | $12,302.69 |
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 $2,398.83 Median $5,370.32 Typical High $11,220.18 | Professional | 52 · Reduced service | $2,398.83 | $5,370.32 | $11,220.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $2,137.96 Typical High $4,466.84 | Professional | 53 · Discontinued | $977.24 | $2,137.96 | $4,466.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $7,943.28 Typical High $16,982.44 | Professional | 54 · Surgery only | $3,630.78 | $7,943.28 | $16,982.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $1,621.81 Typical High $3,388.44 | Professional | 55 · Aftercare only | $724.44 | $1,621.81 | $3,388.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $1,071.52 Typical High $2,238.72 | Professional | 56 · Pre-op care only | $478.63 | $1,071.52 | $2,238.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $7,413.10 Typical High $15,848.93 | Professional | 78 · Unplanned return to OR | $3,388.44 | $7,413.10 | $15,848.93 |
Where Mississippi sits
The same service costs 9.1 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· 39th of 51
$4,786
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.