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 $1,000.00 Typical High $2,570.40 | Facility | None | $758.58 | $1,000.00 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $2,570.40 Typical High $2,570.40 | Professional | None | $870.96 | $2,570.40 | $2,570.40 |
BCBS Mississippi Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $691.83 Median $1,479.11 Typical High $1,698.24 | Professional | None | $691.83 | $1,479.11 | $1,698.24 |
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 $891.25 Median $1,148.15 Typical High $2,041.74 | Professional | None | $891.25 | $1,148.15 | $2,041.74 |
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 $436.52 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $436.52 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $173.78 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $645.65 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $128.82 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $87.10 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $602.56 | $1,778.28 | $1,778.28 |
Where Mississippi sits
The same service costs 5.6 times more in Alaska 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· 23rd of 51
$1,288
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.