How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $2,399 · 10th to 90th $355 to $3,981
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 $3,235.94 Median $9,120.11 Typical High $22,908.68 | Facility | None | $3,235.94 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,818.38 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,818.38 | $3,235.94 | $3,235.94 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,238.72 Median $3,019.95 Typical High $4,897.79 | Professional | None | $2,238.72 | $3,019.95 | $4,897.79 |
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 $2,884.03 Median $3,162.28 Typical High $5,495.41 | Professional | None | $2,884.03 | $3,162.28 | $5,495.41 |
Medcost Setting Facility Modifier None Typical Low $2,137.96 Median $3,235.94 Typical High $7,413.10 | Facility | None | $2,137.96 | $3,235.94 | $7,413.10 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $3,388.44 Typical High $3,801.89 | Professional | None | $2,630.27 | $3,388.44 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $2,089.30 Typical High $3,801.89 | Professional | None | $323.59 | $2,089.30 | $3,801.89 |
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 $2,570.40 Median $3,090.30 Typical High $5,370.32 | Professional | None | $2,570.40 | $3,090.30 | $5,370.32 |
8 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 $1,412.54 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,412.54 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $562.34 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,089.30 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $416.87 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $281.84 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,238.72 | $2,238.72 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $4,897.79 Median $5,128.61 Typical High $7,244.36 | Professional | 50 · Both sides | $4,897.79 | $5,128.61 | $7,244.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,659.59 Median $1,698.24 Typical High $2,398.83 | Professional | 51 · Multiple procedures | $1,659.59 | $1,698.24 | $2,398.83 |
Where South Carolina sits
The same service costs 12.3 times more in Maine than in Washington. 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 $36,075WA $2,929
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.