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 $562.34 Median $1,000.00 Typical High $1,995.26 | Facility | None | $562.34 | $1,000.00 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $1,445.44 Typical High $1,445.44 | Professional | None | $562.34 | $1,445.44 | $1,445.44 |
BCBS Mississippi Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
BCBS Mississippi Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,659.59 Typical High $3,311.31 | Facility | None | $794.33 | $1,659.59 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $954.99 Typical High $1,318.26 | Professional | None | $407.38 | $954.99 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $42.66 Typical High $50.12 | Professional | None | $21.38 | $42.66 | $50.12 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,737.80 Typical High $6,606.93 | Facility | None | $977.24 | $1,737.80 | $6,606.93 |
United Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,905.46 | Professional | None | $645.65 | $977.24 | $1,905.46 |
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 $281.84 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $281.84 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $112.20 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $416.87 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $85.11 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $56.23 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $389.05 | $1,000.00 | $1,000.00 |
Where Mississippi sits
The same service costs 7.4 times more in Oklahoma than in New York. 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· 32nd of 51
$1,000
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.