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 $263.03 Median $758.58 Typical High $1,819.70 | Facility | None | $263.03 | $758.58 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $575.44 Typical High $812.83 | Professional | None | $186.21 | $575.44 | $812.83 |
BCBS Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
BCBS Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $338.84 Typical High $794.33 | Facility | None | $275.42 | $338.84 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $457.09 | Professional | None | $213.80 | $309.03 | $457.09 |
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 $91.20 Median $338.84 Typical High $1,148.15 | Facility | None | $91.20 | $338.84 | $1,148.15 |
United Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $676.08 | Professional | None | $199.53 | $295.12 | $676.08 |
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 $93.33 Median $288.40 Typical High $407.38 | Professional | 52 · Reduced service | $93.33 | $288.40 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $114.82 Typical High $162.18 | Professional | 53 · Discontinued | $37.15 | $114.82 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $426.58 Typical High $602.56 | Professional | 54 · Surgery only | $138.04 | $426.58 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $85.11 Typical High $120.23 | Professional | 55 · Aftercare only | $28.18 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $57.54 Typical High $81.28 | Professional | 56 · Pre-op care only | $18.62 | $57.54 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $398.11 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $128.82 | $398.11 | $562.34 |
Where Mississippi sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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· 27th of 51
$347
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.