How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $1,288 · 10th to 90th $81 to $1,905
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 $1,548.82 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,548.82 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,548.82 | $1,548.82 |
BCBS South Carolina Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $2,137.96 | Professional | None | $954.99 | $1,380.38 | $2,137.96 |
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 $1,288.25 Median $1,548.82 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,548.82 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $3,019.95 | Facility | None | $1,122.02 | $1,548.82 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,905.46 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $1,148.15 Typical High $1,819.70 | Professional | None | $66.07 | $1,148.15 | $1,819.70 |
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 $1,096.48 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,659.59 | $2,754.23 |
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 $549.54 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $549.54 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $218.78 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $831.76 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $165.96 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $109.65 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $776.25 | $1,071.52 | $1,071.52 |
Where South Carolina sits
The same service costs 8.2 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 $15,747MD $1,911
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.