How much rates vary
Facilitymedian $1,905 · 10th to 90th $676 to $13,183Professionalmedian $912 · 10th to 90th $151 to $1,585
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 $5,888.44 Typical High $21,877.62 | Facility | None | $1,445.44 | $5,888.44 | $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 $691.83 Median $1,737.80 Typical High $12,589.25 | Facility | None | $691.83 | $1,737.80 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $1,096.48 | Professional | None | $660.69 | $724.44 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,511.89 | Facility | None | $602.56 | $1,778.28 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $2,187.76 | Professional | None | $691.83 | $691.83 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $851.14 Typical High $2,137.96 | Facility | None | $537.03 | $851.14 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,659.59 | Professional | None | $602.56 | $851.14 | $1,659.59 |
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 $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 $616.60 Median $1,071.52 Typical High $1,949.84 | Professional | None | $616.60 | $1,071.52 | $1,949.84 |
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 $912.01 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $213.80 |
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 $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $851.14 | $1,000.00 | $1,000.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,288.25 Typical High $3,311.31 | Professional | 50 · Both sides | $912.01 | $1,288.25 | $3,311.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $426.58 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $302.00 | $426.58 | $1,122.02 |
Where South Carolina sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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 $9,494KY $2,537
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.