How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,318 to $13,804Professionalmedian $479 · 10th to 90th $89 to $676
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 $524.81 Median $12,022.64 Typical High $21,877.62 | Facility | None | $524.81 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $524.81 | Professional | None | $446.68 | $524.81 | $524.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,621.81 Median $3,890.45 Typical High $12,589.25 | Facility | None | $1,621.81 | $3,890.45 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $794.33 | Professional | None | $416.87 | $630.96 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,862.09 Typical High $2,951.21 | Facility | None | $630.96 | $1,862.09 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $812.83 | Professional | None | $512.86 | $512.86 | $812.83 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $1,318.26 Typical High $2,137.96 | Facility | None | $489.78 | $1,318.26 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $758.58 | Professional | None | $524.81 | $645.65 | $758.58 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $380.19 Typical High $616.60 | Professional | None | $77.62 | $380.19 | $616.60 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $776.25 | Professional | None | $371.54 | $478.63 | $776.25 |
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 $223.87 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $223.87 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $89.13 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $338.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $67.61 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $44.67 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $316.23 | $371.54 | $371.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $977.24 Typical High $1,230.27 | Professional | 50 · Both sides | $794.33 | $977.24 | $1,230.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $331.13 Typical High $407.38 | Professional | 51 · Multiple procedures | $263.03 | $331.13 | $407.38 |
Where South Carolina sits
The same service costs 5.1 times more in Washington, DC than in Montana. 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
DC $7,757MT $1,518
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.