How much rates vary
Facilitymedian $1,778 · 10th to 90th $501 to $10,000Professionalmedian $316 · 10th to 90th $229 to $457
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 $309.03 Median $5,623.41 Typical High $21,877.62 | Facility | None | $309.03 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $389.05 | Professional | None | $269.15 | $309.03 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,862.09 Typical High $8,912.51 | Facility | None | $512.86 | $1,862.09 | $8,912.51 |
BCBS South Carolina Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $407.38 | Professional | None | $245.47 | $316.23 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,479.11 Typical High $2,511.89 | Facility | None | $457.09 | $1,479.11 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $501.19 | Professional | None | $331.13 | $346.74 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $501.19 Typical High $2,137.96 | Facility | None | $309.03 | $501.19 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $794.33 | Professional | None | $309.03 | $363.08 | $794.33 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $416.87 | Professional | None | $204.17 | $281.84 | $416.87 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $501.19 | Professional | None | $229.09 | $295.12 | $501.19 |
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 $134.90 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $134.90 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $53.70 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $199.53 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $39.81 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.92 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $218.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $186.21 | $218.78 | $218.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $724.44 Typical High $1,202.26 | Professional | 50 · Both sides | $524.81 | $724.44 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $239.88 Typical High $398.11 | Professional | 51 · Multiple procedures | $177.83 | $239.88 | $398.11 |
Where South Carolina sits
The same service costs 7.3 times more in Colorado 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
CO $6,269MT $863
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.