How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,096 to $10,715Professionalmedian $1,175 · 10th to 90th $151 to $1,738
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 $1,445.44 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,445.44 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,445.44 | $1,445.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $6,309.57 | Facility | None | $1,778.28 | $2,951.21 | $6,309.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,288.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $7,585.78 | Facility | None | $602.56 | $5,370.32 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,737.80 | $2,290.87 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $3,467.37 | Facility | None | $1,318.26 | $1,584.89 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,445.44 | $1,698.24 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $912.01 Typical High $1,548.82 | Professional | None | $120.23 | $912.01 | $1,548.82 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,348.96 | $2,290.87 |
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 $616.60 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $245.47 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $933.25 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $870.96 | $1,023.29 | $1,023.29 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $2,570.40 Typical High $3,388.44 | Professional | 50 · Both sides | $2,570.40 | $2,570.40 | $3,388.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $851.14 | $851.14 | $1,174.90 |
Where South Carolina sits
The same service costs 6.1 times more in Alaska than in Texas. 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 $14,041TX $2,290
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.