How much rates vary
Facilitymedian $977 · 10th to 90th $437 to $8,511Professionalmedian $912 · 10th to 90th $135 to $1,514
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 $1,047.13 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,047.13 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,047.13 | Professional | None | $870.96 | $1,047.13 | $1,047.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $1,621.81 | Professional | None | $870.96 | $912.01 | $1,621.81 |
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 $933.25 Median $1,071.52 Typical High $1,949.84 | Professional | None | $933.25 | $1,071.52 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $2,454.71 | Facility | None | $645.65 | $1,047.13 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,479.11 | Professional | None | $891.25 | $1,047.13 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $794.33 Typical High $1,513.56 | Professional | None | $123.03 | $794.33 | $1,513.56 |
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 $831.76 Median $1,000.00 Typical High $1,778.28 | Professional | None | $831.76 | $1,000.00 | $1,778.28 |
7 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 $436.52 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $436.52 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $173.78 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $660.69 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $131.83 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $87.10 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $616.60 | $741.31 | $741.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $524.81 Typical High $794.33 | Professional | 51 · Multiple procedures | $512.86 | $524.81 | $794.33 |
Where South Carolina sits
The same service costs 10.1 times more in Maine than in Arkansas. 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 $16,050AR $1,584
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.