How much rates vary
Facilitymedian $1,778 · 10th to 90th $708 to $10,233Professionalmedian $501 · 10th to 90th $162 to $794
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 $489.78 Median $1,023.29 Typical High $20,417.38 | Facility | None | $489.78 | $1,023.29 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $676.08 | Professional | None | $457.09 | $588.84 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $776.25 | Professional | None | $588.84 | $588.84 | $776.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,090.30 Typical High $9,120.11 | Facility | None | $851.14 | $3,090.30 | $9,120.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $707.95 | Professional | None | $389.05 | $478.63 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $2,238.72 | Facility | None | $602.56 | $1,380.38 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $794.33 | Professional | None | $407.38 | $524.81 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $416.87 Median $676.08 Typical High $1,698.24 | Facility | None | $416.87 | $676.08 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $707.95 | Professional | None | $501.19 | $602.56 | $707.95 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $524.81 Typical High $812.83 | Professional | None | $79.43 | $524.81 | $812.83 |
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 $371.54 Median $501.19 Typical High $851.14 | Professional | None | $371.54 | $501.19 | $851.14 |
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 $245.47 Median $245.47 Typical High $338.84 | Professional | 52 · Reduced service | $245.47 | $245.47 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $134.90 | Professional | 53 · Discontinued | $97.72 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $512.86 | Professional | 54 · Surgery only | $363.08 | $363.08 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $102.33 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $67.61 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $478.63 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $302.00 Typical High $446.68 | Professional | 51 · Multiple procedures | $251.19 | $302.00 | $446.68 |
Where South Carolina sits
The same service costs 5.2 times more in Colorado than in West Virginia. 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 $6,580WV $1,277
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.