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 $1,584.89 Median $3,311.31 Typical High $4,897.79 | Professional | None | $1,584.89 | $3,311.31 | $4,897.79 |
BCBS Mississippi Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
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 $1,584.89 Median $2,630.27 Typical High $2,754.23 | Professional | None | $1,584.89 | $2,630.27 | $2,754.23 |
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 $1,548.82 Median $1,819.70 Typical High $4,168.69 | Professional | None | $1,548.82 | $1,819.70 | $4,168.69 |
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 $794.33 Median $1,659.59 Typical High $2,454.71 | Professional | 52 · Reduced service | $794.33 | $1,659.59 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $660.69 Typical High $977.24 | Professional | 53 · Discontinued | $316.23 | $660.69 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $2,511.89 Typical High $3,630.78 | Professional | 54 · Surgery only | $1,174.90 | $2,511.89 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $501.19 Typical High $724.44 | Professional | 55 · Aftercare only | $239.88 | $501.19 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $331.13 Typical High $489.78 | Professional | 56 · Pre-op care only | $158.49 | $331.13 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $2,344.23 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $1,096.48 | $2,344.23 | $3,388.44 |
Where Mississippi sits
The same service costs 5.4 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· 16th of 51
$2,512
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.