How much rates vary
Facilitymedian $550 · 10th to 90th $151 to $1,122Professionalmedian $501 · 10th to 90th $102 to $741
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 $524.81 Median $4,897.79 Typical High $21,877.62 | Facility | None | $524.81 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $575.44 | Professional | None | $478.63 | $524.81 | $575.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $302.00 Median $575.44 Typical High $794.33 | Facility | None | $302.00 | $575.44 | $794.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $562.34 | Professional | None | $426.58 | $501.19 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $371.54 Typical High $707.95 | Facility | None | $151.36 | $371.54 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $831.76 | Professional | None | $501.19 | $537.03 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $501.19 Typical High $776.25 | Facility | None | $104.71 | $501.19 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $691.83 | Professional | None | $489.78 | $575.44 | $691.83 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $436.52 Typical High $724.44 | Professional | None | $79.43 | $436.52 | $724.44 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $776.25 | Professional | None | $380.19 | $489.78 | $776.25 |
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 $245.47 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $245.47 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $97.72 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $363.08 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $398.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,047.13 Typical High $1,348.96 | Professional | 50 · Both sides | $741.31 | $1,047.13 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $346.74 Typical High $446.68 | Professional | 51 · Multiple procedures | $245.47 | $346.74 | $446.68 |
Where South Carolina sits
The same service costs 4.7 times more in New York 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
NY $3,038FL $649
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.