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 $1,318.26 Typical High $2,818.38 | Facility | None | $758.58 | $1,318.26 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $7,244.36 Typical High $7,244.36 | Professional | None | $2,290.87 | $7,244.36 | $7,244.36 |
BCBS Mississippi Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
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 $1,778.28 Median $3,801.89 Typical High $4,677.35 | Professional | None | $1,778.28 | $3,801.89 | $4,677.35 |
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 $2,238.72 Median $2,691.53 Typical High $6,165.95 | Professional | None | $2,238.72 | $2,691.53 | $6,165.95 |
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 $1,148.15 Median $3,630.78 Typical High $3,630.78 | Professional | 52 · Reduced service | $1,148.15 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $1,445.44 Typical High $1,445.44 | Professional | 53 · Discontinued | $457.09 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $5,495.41 Typical High $5,495.41 | Professional | 54 · Surgery only | $1,698.24 | $5,495.41 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $1,096.48 Typical High $1,096.48 | Professional | 55 · Aftercare only | $346.74 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $724.44 Typical High $724.44 | Professional | 56 · Pre-op care only | $229.09 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $5,128.61 Typical High $5,128.61 | Professional | 78 · Unplanned return to OR | $1,584.89 | $5,128.61 | $5,128.61 |
Where Mississippi sits
The same service costs 10.0 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· 34th of 51
$2,818
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.