How much rates vary
Facilitymedian $1,000 · 10th to 90th $603 to $6,918Professionalmedian $447 · 10th to 90th $126 to $724
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 $380.19 Median $5,623.41 Typical High $21,877.62 | Facility | None | $380.19 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $691.83 | Professional | None | $380.19 | $501.19 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $467.74 Typical High $588.84 | Professional | None | $234.42 | $467.74 | $588.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,288.25 Typical High $6,760.83 | Facility | None | $691.83 | $1,288.25 | $6,760.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $537.03 | Professional | None | $302.00 | $426.58 | $537.03 |
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 $346.74 Median $537.03 Typical High $831.76 | Professional | None | $346.74 | $537.03 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $323.59 Median $645.65 Typical High $1,202.26 | Facility | None | $323.59 | $645.65 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $707.95 | Professional | None | $489.78 | $562.34 | $707.95 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $436.52 Typical High $741.31 | Professional | None | $38.90 | $436.52 | $741.31 |
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 $275.42 Median $446.68 Typical High $741.31 | Professional | None | $275.42 | $446.68 | $741.31 |
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 $190.55 Median $213.80 Typical High $302.00 | Professional | 52 · Reduced service | $190.55 | $213.80 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $120.23 | Professional | 53 · Discontinued | $75.86 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $323.59 Typical High $457.09 | Professional | 54 · Surgery only | $281.84 | $323.59 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $64.57 Typical High $91.20 | Professional | 55 · Aftercare only | $56.23 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $60.26 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $302.00 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $263.03 | $302.00 | $426.58 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $831.76 Typical High $1,412.54 | Professional | 50 · Both sides | $741.31 | $831.76 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $281.84 Typical High $467.74 | Professional | 51 · Multiple procedures | $245.47 | $281.84 | $467.74 |
Where South Carolina sits
The same service costs 4.4 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 $4,902MD $1,113
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.