How much rates vary
Facilitymedian $3,020 · 10th to 90th $933 to $19,498Professionalmedian $537 · 10th to 90th $89 to $794
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 $660.69 Median $9,120.11 Typical High $20,417.38 | Facility | None | $660.69 | $9,120.11 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $831.76 | Professional | None | $562.34 | $660.69 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $954.99 | Professional | None | $288.40 | $524.81 | $954.99 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $6,025.60 Typical High $18,197.01 | Facility | None | $1,122.02 | $6,025.60 | $18,197.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $707.95 | Professional | None | $524.81 | $562.34 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $2,818.38 | Facility | None | $630.96 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $1,023.29 | Professional | None | $549.54 | $602.56 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $645.65 Median $912.01 Typical High $2,290.87 | Facility | None | $645.65 | $912.01 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $912.01 | Professional | None | $630.96 | $660.69 | $912.01 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $316.23 Typical High $724.44 | Professional | None | $75.86 | $316.23 | $724.44 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $912.01 | Professional | None | $467.74 | $575.44 | $912.01 |
7 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 $281.84 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $281.84 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $112.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $426.58 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $85.11 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $56.23 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $398.11 | $467.74 | $467.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $338.84 Typical High $512.86 | Professional | 51 · Multiple procedures | $316.23 | $338.84 | $512.86 |
Where South Carolina sits
The same service costs 4.7 times more in Oklahoma than in Montana. 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
OK $8,820MT $1,888
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.