How much rates vary
Facilitymedian $1,000 · 10th to 90th $603 to $7,079Professionalmedian $407 · 10th to 90th $60 to $741
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 $371.54 Median $5,623.41 Typical High $21,877.62 | Facility | None | $371.54 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $588.84 | Professional | None | $338.84 | $398.11 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,288.25 Typical High $6,760.83 | Facility | None | $676.08 | $1,288.25 | $6,760.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $524.81 | Professional | None | $213.80 | $302.00 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $831.76 Typical High $1,348.96 | Facility | None | $602.56 | $831.76 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $776.25 | Professional | None | $199.53 | $288.40 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $645.65 Typical High $954.99 | Facility | None | $169.82 | $645.65 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $676.08 | Professional | None | $269.15 | $426.58 | $676.08 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $537.03 Typical High $831.76 | Professional | None | $37.15 | $537.03 | $831.76 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $691.83 | Professional | None | $239.88 | $380.19 | $691.83 |
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 $186.21 Median $208.93 Typical High $295.12 | Professional | 52 · Reduced service | $186.21 | $208.93 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $117.49 | Professional | 53 · Discontinued | $75.86 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $316.23 Typical High $436.52 | Professional | 54 · Surgery only | $281.84 | $316.23 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $63.10 Typical High $87.10 | Professional | 55 · Aftercare only | $56.23 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $42.66 Typical High $58.88 | Professional | 56 · Pre-op care only | $37.15 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $295.12 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $263.03 | $295.12 | $407.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $645.65 Typical High $1,348.96 | Professional | 50 · Both sides | $407.38 | $645.65 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $218.78 Typical High $457.09 | Professional | 51 · Multiple procedures | $134.90 | $218.78 | $457.09 |
Where South Carolina sits
The same service costs 4.5 times more in Colorado than in Maryland. 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 $4,866MD $1,088
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.