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 $1,949.84 Median $6,165.95 Typical High $6,165.95 | Professional | None | $1,949.84 | $6,165.95 | $6,165.95 |
BCBS Mississippi Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
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 $1,513.56 Median $3,235.94 Typical High $3,801.89 | Professional | None | $1,513.56 | $3,235.94 | $3,801.89 |
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 $1,819.70 Median $2,398.83 Typical High $5,248.07 | Professional | None | $1,819.70 | $2,398.83 | $5,248.07 |
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 $977.24 Median $3,090.30 Typical High $3,090.30 | Professional | 52 · Reduced service | $977.24 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $1,258.93 Typical High $1,258.93 | Professional | 53 · Discontinued | $389.05 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $4,677.35 Typical High $4,677.35 | Professional | 54 · Surgery only | $1,479.11 | $4,677.35 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $933.25 Typical High $933.25 | Professional | 55 · Aftercare only | $295.12 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $616.60 Typical High $616.60 | Professional | 56 · Pre-op care only | $194.98 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $4,365.16 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $1,380.38 | $4,365.16 | $4,365.16 |
Where Mississippi sits
The same service costs 8.1 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· 33rd of 51
$2,455
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.