How much rates vary
Facilitymedian $282 · 10th to 90th $74 to $1,122Professionalmedian $123 · 10th to 90th $59 to $186
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 $64.57 Median $123.03 Typical High $436.52 | Facility | None | $64.57 | $123.03 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $123.03 Typical High $186.21 | Professional | None | $64.57 | $123.03 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $223.87 | Professional | None | $60.26 | $87.10 | $223.87 |
BCBS South Carolina Setting Facility Modifier None Typical Low $173.78 Median $338.84 Typical High $588.84 | Facility | None | $173.78 | $338.84 | $588.84 |
BCBS South Carolina Setting Professional Modifier None Typical Low $54.95 Median $125.89 Typical High $162.18 | Professional | None | $54.95 | $125.89 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $114.82 Typical High $158.49 | Professional | None | $67.61 | $114.82 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $52.48 Median $69.18 Typical High $141.25 | Facility | None | $52.48 | $69.18 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $213.80 | Professional | None | $104.71 | $144.54 | $213.80 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $229.09 | Professional | None | $125.89 | $154.88 | $229.09 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $52.48 Median $97.72 Typical High $186.21 | Professional | None | $52.48 | $97.72 | $186.21 |
6 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 $32.36 Median $32.36 Typical High $61.66 | Professional | 52 · Reduced service | $32.36 | $32.36 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $24.55 | Professional | 53 · Discontinued | $12.88 | $12.88 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $91.20 | Professional | 54 · Surgery only | $47.86 | $47.86 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $18.62 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $12.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $52.48 Median $81.28 Typical High $107.15 | Professional | 51 · Multiple procedures | $52.48 | $81.28 | $107.15 |
Where South Carolina sits
The same service costs 12.9 times more in Colorado than in Maine. 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 $2,408ME $187
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.