How much rates vary
Facilitymedian $3,802 · 10th to 90th $933 to $13,804Professionalmedian $646 · 10th to 90th $102 to $1,000
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 $758.58 Median $9,549.93 Typical High $20,417.38 | Facility | None | $758.58 | $9,549.93 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $758.58 | Professional | None | $645.65 | $758.58 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $4,168.69 Typical High $12,882.50 | Facility | None | $1,047.13 | $4,168.69 | $12,882.50 |
BCBS South Carolina Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $1,000.00 | Professional | None | $616.60 | $660.69 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $5,623.41 | Facility | None | $630.96 | $2,951.21 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,230.27 | Professional | None | $758.58 | $794.33 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $912.01 Typical High $2,089.30 | Facility | None | $741.31 | $912.01 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,023.29 | Professional | None | $758.58 | $831.76 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $489.78 Typical High $851.14 | Professional | None | $79.43 | $489.78 | $851.14 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,174.90 | Professional | None | $549.54 | $691.83 | $1,174.90 |
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 $323.59 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $524.81 | $524.81 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,412.54 Typical High $1,778.28 | Professional | 50 · Both sides | $1,202.26 | $1,412.54 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $478.63 Typical High $588.84 | Professional | 51 · Multiple procedures | $407.38 | $478.63 | $588.84 |
Where South Carolina sits
The same service costs 4.8 times more in Alaska 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
AK $10,454MT $2,169
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.