How much rates vary
Facilitymedian $1,230 · 10th to 90th $457 to $9,333Professionalmedian $1,148 · 10th to 90th $81 to $1,698
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 $1,348.96 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,348.96 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,187.76 | Professional | None | $977.24 | $1,348.96 | $2,187.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $2,137.96 | Professional | None | $851.14 | $1,288.25 | $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 $1,202.26 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,380.38 | $2,290.87 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,630.27 | Facility | None | $1,122.02 | $1,348.96 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,445.44 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $1,023.29 Typical High $1,621.81 | Professional | None | $66.07 | $1,023.29 | $1,621.81 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $9,120.11 | Facility | None | $416.87 | $1,258.93 | $9,120.11 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,584.89 Typical High $2,454.71 | Professional | None | $977.24 | $1,584.89 | $2,454.71 |
4 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 54 · Surgery only Typical Low $724.44 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $724.44 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $144.54 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $95.50 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $676.08 | $933.25 | $933.25 |
Where South Carolina sits
The same service costs 9.4 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 $15,900MD $1,684
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.