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 $776.25 Median $1,318.26 Typical High $4,570.88 | Facility | None | $776.25 | $1,318.26 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $9,549.93 Typical High $13,803.84 | Professional | None | $4,570.88 | $9,549.93 | $13,803.84 |
BCBS Mississippi Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Professional | None | $8,317.64 | $8,317.64 | $8,317.64 |
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 $4,677.35 Median $7,585.78 Typical High $7,943.28 | Professional | None | $4,677.35 | $7,585.78 | $7,943.28 |
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 $4,365.16 Median $5,128.61 Typical High $12,302.69 | Professional | None | $4,365.16 | $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 $2,290.87 Median $4,786.30 Typical High $6,918.31 | Professional | 52 · Reduced service | $2,290.87 | $4,786.30 | $6,918.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $1,905.46 Typical High $2,818.38 | Professional | 53 · Discontinued | $912.01 | $1,905.46 | $2,818.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $7,244.36 Typical High $10,471.29 | Professional | 54 · Surgery only | $3,388.44 | $7,244.36 | $10,471.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $1,445.44 Typical High $2,089.30 | Professional | 55 · Aftercare only | $676.08 | $1,445.44 | $2,089.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $954.99 Typical High $1,380.38 | Professional | 56 · Pre-op care only | $457.09 | $954.99 | $1,380.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $6,760.83 Typical High $9,772.37 | Professional | 78 · Unplanned return to OR | $3,162.28 | $6,760.83 | $9,772.37 |
Where Mississippi sits
The same service costs 20.0 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· 16th of 51
$7,244
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.