How much rates vary
Facilitymedian $912 · 10th to 90th $501 to $3,090Professionalmedian $468 · 10th to 90th $89 to $646
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 $467.74 Median $5,623.41 Typical High $21,877.62 | Facility | None | $467.74 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $501.19 | Professional | None | $426.58 | $467.74 | $501.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $912.01 Typical High $2,187.76 | Facility | None | $676.08 | $912.01 | $2,187.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $537.03 | Professional | None | $398.11 | $467.74 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $1,584.89 | Facility | None | $602.56 | $977.24 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $741.31 | Professional | None | $436.52 | $467.74 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $588.84 Typical High $1,174.90 | Facility | None | $281.84 | $588.84 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $630.96 | Professional | None | $446.68 | $501.19 | $630.96 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $380.19 Typical High $676.08 | Professional | None | $38.90 | $380.19 | $676.08 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,606.93 | Facility | None | $302.00 | $1,122.02 | $6,606.93 |
United Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $676.08 | Professional | None | $331.13 | $426.58 | $676.08 |
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 $213.80 Median $229.09 Typical High $251.19 | Professional | 52 · Reduced service | $213.80 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $100.00 | Professional | 53 · Discontinued | $85.11 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $346.74 Typical High $380.19 | Professional | 54 · Surgery only | $323.59 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $75.86 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $50.12 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $323.59 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $302.00 | $323.59 | $354.81 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $933.25 Typical High $1,174.90 | Professional | 50 · Both sides | $676.08 | $933.25 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $316.23 Typical High $389.05 | Professional | 51 · Multiple procedures | $223.87 | $316.23 | $389.05 |
Where South Carolina sits
The same service costs 4.5 times more in Vermont than in Florida. 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
VT $4,521FL $1,007
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.