How much rates vary
Facilitymedian $1,445 · 10th to 90th $631 to $9,120Professionalmedian $229 · 10th to 90th $158 to $347
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 $190.55 Median $5,623.41 Typical High $21,877.62 | Facility | None | $190.55 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $281.84 | Professional | None | $186.21 | $239.88 | $281.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,621.81 Typical High $7,943.28 | Facility | None | $691.83 | $1,621.81 | $7,943.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $295.12 | Professional | None | $162.18 | $181.97 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,348.96 Typical High $1,995.26 | Facility | None | $602.56 | $1,348.96 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $338.84 | Professional | None | $181.97 | $234.42 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $588.84 Typical High $1,479.11 | Facility | None | $190.55 | $588.84 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $309.03 | Professional | None | $194.98 | $275.42 | $309.03 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $263.03 Typical High $398.11 | Professional | None | $33.88 | $263.03 | $398.11 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $363.08 | Professional | None | $147.91 | $218.78 | $363.08 |
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 $95.50 Median $95.50 Typical High $141.25 | Professional | 52 · Reduced service | $95.50 | $95.50 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $56.23 | Professional | 53 · Discontinued | $38.90 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $213.80 | Professional | 54 · Surgery only | $144.54 | $144.54 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $42.66 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $28.18 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $134.90 | $134.90 | $199.53 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 51 · Multiple procedures | $223.87 | $223.87 | $223.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $138.04 Typical High $186.21 | Professional | 51 · Multiple procedures | $97.72 | $138.04 | $186.21 |
Where South Carolina sits
The same service costs 9.3 times more in Colorado than in Montana. 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
CO $5,912MT $637
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.