How much rates vary
Facilitymedian $1,479 · 10th to 90th $692 to $4,467Professionalmedian $251 · 10th to 90th $155 to $417
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 $204.17 Median $758.58 Typical High $1,819.70 | Facility | None | $204.17 | $758.58 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $323.59 Typical High $380.19 | Professional | None | $154.88 | $323.59 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $218.78 | Professional | None | $138.04 | $177.83 | $218.78 |
BCBS Mississippi Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
BCBS Mississippi Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $3,235.94 | Facility | None | $630.96 | $1,659.59 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $323.59 | Professional | None | $169.82 | $251.19 | $323.59 |
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 $758.58 Median $1,412.54 Typical High $5,888.44 | Facility | None | $758.58 | $1,412.54 | $5,888.44 |
United Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $407.38 | Professional | None | $169.82 | $190.55 | $407.38 |
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 $77.62 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $77.62 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $30.90 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $117.49 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $23.44 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $15.49 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $263.03 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $109.65 | $263.03 | $263.03 |
Where Mississippi sits
The same service costs 8.1 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,634MT $570
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.