How much rates vary
Facilitymedian $1,259 · 10th to 90th $457 to $9,333Professionalmedian $1,288 · 10th to 90th $832 to $1,995
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 $1,584.89 Median $12,589.25 Typical High $21,877.62 | Facility | None | $1,584.89 | $12,589.25 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,584.89 | $1,584.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,258.93 | $1,862.09 |
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 $1,380.38 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,380.38 | $1,513.56 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $3,090.30 | Facility | None | $1,202.26 | $1,584.89 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,513.56 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $1,288.25 Typical High $1,949.84 | Professional | None | $131.83 | $1,288.25 | $1,949.84 |
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 $1,122.02 Median $1,698.24 Typical High $2,884.03 | Professional | None | $1,122.02 | $1,698.24 | $2,884.03 |
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 $562.34 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $562.34 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $223.87 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $851.14 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $169.82 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $112.20 | $158.49 | $158.49 |
Where South Carolina sits
The same service costs 15.0 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 $27,402MD $1,821
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.