How much rates vary
Facilitymedian $912 · 10th to 90th $437 to $9,120Professionalmedian $389 · 10th to 90th $282 to $617
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 $436.52 Median $5,623.41 Typical High $21,877.62 | Facility | None | $436.52 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $436.52 | Professional | None | $316.23 | $436.52 | $436.52 |
BCBS South Carolina Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $524.81 | Professional | None | $281.84 | $354.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $1,905.46 | Facility | None | $588.84 | $851.14 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $741.31 | Professional | None | $389.05 | $426.58 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $436.52 Typical High $870.96 | Facility | None | $331.13 | $436.52 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $467.74 | Professional | None | $363.08 | $426.58 | $467.74 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $616.60 | Professional | None | $295.12 | $436.52 | $616.60 |
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 $316.23 Median $478.63 Typical High $794.33 | Professional | None | $316.23 | $478.63 | $794.33 |
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 $154.88 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $154.88 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $63.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $234.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $46.77 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $31.62 | $43.65 | $43.65 |
Where South Carolina sits
The same service costs 30.0 times more in Maine than in Delaware. 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 $26,760DE $893
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.