How much rates vary
Facilitymedian $794 · 10th to 90th $380 to $2,344Professionalmedian $316 · 10th to 90th $51 to $490
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 $407.38 Median $5,623.41 Typical High $21,877.62 | Facility | None | $407.38 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $467.74 | Professional | None | $346.74 | $407.38 | $467.74 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $831.76 Typical High $2,187.76 | Facility | None | $501.19 | $831.76 | $2,187.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $380.19 | Professional | None | $239.88 | $323.59 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $954.99 Typical High $1,445.44 | Facility | None | $457.09 | $954.99 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $354.81 Typical High $645.65 | Professional | None | $346.74 | $354.81 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $380.19 Typical High $1,174.90 | Facility | None | $245.47 | $380.19 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $478.63 | Professional | None | $331.13 | $407.38 | $478.63 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $263.03 Typical High $489.78 | Professional | None | $38.90 | $263.03 | $489.78 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $562.34 | Professional | None | $275.42 | $346.74 | $562.34 |
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 $169.82 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $169.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $257.04 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $51.29 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $34.67 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $281.84 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $239.88 | $281.84 | $281.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $616.60 Typical High $954.99 | Professional | 50 · Both sides | $501.19 | $616.60 | $954.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $204.17 Typical High $316.23 | Professional | 51 · Multiple procedures | $165.96 | $204.17 | $316.23 |
Where South Carolina sits
The same service costs 5.9 times more in Colorado 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
CO $4,303KY $729
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.