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 $223.87 Median $758.58 Typical High $1,819.70 | Facility | None | $223.87 | $758.58 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $446.68 Typical High $676.08 | Professional | None | $151.36 | $446.68 | $676.08 |
BCBS Mississippi Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
BCBS Mississippi Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $234.42 Typical High $524.81 | Facility | None | $190.55 | $234.42 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $389.05 | Professional | None | $173.78 | $251.19 | $389.05 |
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 $467.74 Median $758.58 Typical High $5,370.32 | Facility | None | $467.74 | $758.58 | $5,370.32 |
United Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $537.03 | Professional | None | $158.49 | $239.88 | $537.03 |
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 $74.13 Median $223.87 Typical High $338.84 | Professional | 52 · Reduced service | $74.13 | $223.87 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $91.20 Typical High $138.04 | Professional | 53 · Discontinued | $29.51 | $91.20 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $338.84 Typical High $512.86 | Professional | 54 · Surgery only | $109.65 | $338.84 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $67.61 Typical High $102.33 | Professional | 55 · Aftercare only | $21.88 | $67.61 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $44.67 Typical High $67.61 | Professional | 56 · Pre-op care only | $14.79 | $44.67 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $316.23 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $102.33 | $316.23 | $478.63 |
Where Mississippi sits
The same service costs 4.3 times more in Wisconsin than in Kentucky. 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· 20th of 51
$309
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.