How much rates vary
Facilitymedian $1,259 · 10th to 90th $457 to $10,471Professionalmedian $1,445 · 10th to 90th $117 to $2,239
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 $1,862.09 Median $11,481.54 Typical High $21,877.62 | Facility | None | $1,862.09 | $11,481.54 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,862.09 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,513.56 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,995.26 | Facility | None | $100.00 | $794.33 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,659.59 | $1,819.70 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $3,630.78 | Facility | None | $1,412.54 | $1,862.09 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $1,995.26 | Professional | None | $1,548.82 | $1,819.70 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $1,288.25 Typical High $2,187.76 | Professional | None | $109.65 | $1,288.25 | $2,187.76 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $3,388.44 | Professional | None | $1,318.26 | $2,041.74 | $3,388.44 |
5 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 $660.69 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $660.69 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $269.15 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,000.00 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $199.53 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $134.90 | $186.21 | $186.21 |
Where South Carolina sits
The same service costs 25.6 times more in Maine than in Maryland. 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
ME $53,236MD $2,076
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.