How much rates vary
Facilitymedian $6,918 · 10th to 90th $2,570 to $33,113Professionalmedian $5,370 · 10th to 90th $537 to $9,550
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 $537.03 Median $9,120.11 Typical High $20,417.38 | Facility | None | $537.03 | $9,120.11 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $4,786.30 Typical High $6,760.83 | Professional | None | $537.03 | $4,786.30 | $6,760.83 |
Ambetter Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,548.13 Median $7,079.46 Typical High $35,481.34 | Facility | None | $3,548.13 | $7,079.46 | $35,481.34 |
BCBS South Carolina Setting Professional Modifier None Typical Low $407.38 Median $933.25 Typical High $6,918.31 | Professional | None | $407.38 | $933.25 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,168.69 Typical High $7,244.36 | Facility | None | $602.56 | $4,168.69 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,230.27 Typical High $9,772.37 | Professional | None | $630.96 | $1,230.27 | $9,772.37 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $3,801.89 Typical High $7,762.47 | Facility | None | $537.03 | $3,801.89 | $7,762.47 |
Medcost Setting Professional Modifier None Typical Low $6,456.54 Median $9,549.93 Typical High $9,549.93 | Professional | None | $6,456.54 | $9,549.93 | $9,549.93 |
Molina Setting Professional Modifier None Typical Low $630.96 Median $5,623.41 Typical High $8,511.38 | Professional | None | $630.96 | $5,623.41 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,165.95 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,165.95 | $23,988.33 |
United Setting Professional Modifier None Typical Low $426.58 Median $4,365.16 Typical High $10,964.78 | Professional | None | $426.58 | $4,365.16 | $10,964.78 |
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 $269.15 Median $371.54 Typical High $3,235.94 | Professional | 52 · Reduced service | $269.15 | $371.54 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $147.91 Typical High $1,288.25 | Professional | 53 · Discontinued | $109.65 | $147.91 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $549.54 Typical High $4,786.30 | Professional | 54 · Surgery only | $407.38 | $549.54 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $109.65 Typical High $954.99 | Professional | 55 · Aftercare only | $81.28 | $109.65 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $74.13 Typical High $645.65 | Professional | 56 · Pre-op care only | $53.70 | $74.13 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $512.86 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $380.19 | $512.86 | $4,466.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3,981.07 Median $4,786.30 Typical High $5,370.32 | Professional | 51 · Multiple procedures | $3,981.07 | $4,786.30 | $5,370.32 |
Where South Carolina sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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
OK $20,151MS $3,466
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.