How much rates vary
Facilitymedian $1,288 · 10th to 90th $457 to $9,333Professionalmedian $1,479 · 10th to 90th $138 to $2,455
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 $2,089.30 Median $10,964.78 Typical High $21,877.62 | Facility | None | $2,089.30 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,479.11 | $2,089.30 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,659.59 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $3,548.13 | Professional | None | $1,819.70 | $2,041.74 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $4,073.80 | Facility | None | $1,584.89 | $2,089.30 | $4,073.80 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,187.76 | Professional | None | $1,698.24 | $2,041.74 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $1,318.26 Typical High $2,398.83 | Professional | None | $131.83 | $1,318.26 | $2,398.83 |
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 $1,479.11 Median $2,238.72 Typical High $3,801.89 | Professional | None | $1,479.11 | $2,238.72 | $3,801.89 |
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 $741.31 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $741.31 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $295.12 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,122.02 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $223.87 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $147.91 | $208.93 | $208.93 |
Where South Carolina sits
The same service costs 24.1 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 $53,525MD $2,222
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.