How much rates vary
Facilitymedian $1,905 · 10th to 90th $692 to $10,233Professionalmedian $468 · 10th to 90th $105 to $871
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 $457.09 Median $676.08 Typical High $16,595.87 | Facility | None | $457.09 | $676.08 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $870.96 | Professional | None | $416.87 | $512.86 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
BCBS South Carolina Setting Facility Modifier None Typical Low $891.25 Median $3,162.28 Typical High $9,120.11 | Facility | None | $891.25 | $3,162.28 | $9,120.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $676.08 | Professional | None | $389.05 | $457.09 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,454.71 | Facility | None | $602.56 | $1,737.80 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $1,000.00 | Professional | None | $389.05 | $489.78 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $1,698.24 | Facility | None | $371.54 | $645.65 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $691.83 | Professional | None | $426.58 | $562.34 | $691.83 |
Molina Setting Professional Modifier None Typical Low $87.10 Median $467.74 Typical High $891.25 | Professional | None | $87.10 | $467.74 | $891.25 |
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 $389.05 Median $512.86 Typical High $891.25 | Professional | None | $389.05 | $512.86 | $891.25 |
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 $208.93 Median $223.87 Typical High $281.84 | Professional | 52 · Reduced service | $208.93 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $112.20 | Professional | 53 · Discontinued | $83.18 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $309.03 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $56.23 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $316.23 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $288.40 | $316.23 | $389.05 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $831.76 Typical High $1,380.38 | Professional | 50 · Both sides | $645.65 | $831.76 | $1,380.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $213.80 Median $275.42 Typical High $457.09 | Professional | 51 · Multiple procedures | $213.80 | $275.42 | $457.09 |
Where South Carolina sits
The same service costs 7.2 times more in Vermont 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
VT $9,370ME $1,294
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.