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 $549.54 Median $794.33 Typical High $1,819.70 | Facility | None | $549.54 | $794.33 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $794.33 Typical High $794.33 | Professional | None | $316.23 | $794.33 | $794.33 |
BCBS Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $338.84 Median $562.34 Typical High $741.31 | Professional | None | $338.84 | $562.34 | $741.31 |
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 $416.87 Median $467.74 Typical High $912.01 | Professional | None | $416.87 | $467.74 | $912.01 |
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 $158.49 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $158.49 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $63.10 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $234.42 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $46.77 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $31.62 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $218.78 | $549.54 | $549.54 |
Where Mississippi sits
The same service costs 7.4 times more in Oklahoma 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· 20th of 51
$661
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.