How much rates vary
Facilitymedian $1,072 · 10th to 90th $457 to $9,333Professionalmedian $891 · 10th to 90th $562 to $1,380
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 $1,071.52 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,071.52 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,071.52 | Professional | None | $776.25 | $1,071.52 | $1,071.52 |
BCBS South Carolina Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,288.25 | Professional | None | $691.83 | $870.96 | $1,288.25 |
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 $954.99 Median $1,071.52 Typical High $1,819.70 | Professional | None | $954.99 | $1,071.52 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,071.52 Typical High $2,137.96 | Facility | None | $812.83 | $1,071.52 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,148.15 | Professional | None | $891.25 | $1,071.52 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $891.25 Typical High $1,318.26 | Professional | None | $66.07 | $891.25 | $1,318.26 |
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 $776.25 Median $1,174.90 Typical High $1,949.84 | Professional | None | $776.25 | $1,174.90 | $1,949.84 |
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 $389.05 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $389.05 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $154.88 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $575.44 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $114.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $77.62 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $537.03 | $758.58 | $758.58 |
Where South Carolina sits
The same service costs 18.7 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 $26,826MD $1,433
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.