How much rates vary
Facilitymedian $3,388 · 10th to 90th $676 to $16,982Professionalmedian $676 · 10th to 90th $107 to $1,148
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 $831.76 Median $5,623.41 Typical High $21,877.62 | Facility | None | $831.76 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $851.14 | Professional | None | $707.95 | $831.76 | $851.14 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $3,235.94 Typical High $16,982.44 | Facility | None | $691.83 | $3,235.94 | $16,982.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,318.26 | Professional | None | $676.08 | $812.83 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $4,897.79 | Facility | None | $602.56 | $1,995.26 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $1,000.00 Typical High $1,737.80 | Professional | None | $407.38 | $1,000.00 | $1,737.80 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $851.14 Typical High $2,290.87 | Facility | None | $537.03 | $851.14 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $954.99 Typical High $1,621.81 | Professional | None | $407.38 | $954.99 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $562.34 Typical High $1,096.48 | Professional | None | $91.20 | $562.34 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $5,011.87 Typical High $24,547.09 | Facility | None | $1,445.44 | $5,011.87 | $24,547.09 |
United Setting Professional Modifier None Typical Low $436.52 Median $954.99 Typical High $1,698.24 | Professional | None | $436.52 | $954.99 | $1,698.24 |
9 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 $371.54 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $371.54 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $74.13 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $575.44 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 50 · Both sides | $1,096.48 | $1,096.48 | $1,096.48 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $1,412.54 Typical High $2,754.23 | Professional | 50 · Both sides | $602.56 | $1,412.54 | $2,754.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $478.63 Typical High $812.83 | Professional | 51 · Multiple procedures | $204.17 | $478.63 | $812.83 |
Where South Carolina sits
The same service costs 6.0 times more in Colorado than in Hawaii. 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 $12,924HI $2,150
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.