How much rates vary
Facilitymedian $1,445 · 10th to 90th $661 to $10,233Professionalmedian $537 · 10th to 90th $102 to $813
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 $478.63 Median $5,623.41 Typical High $21,877.62 | Facility | None | $478.63 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $676.08 | Professional | None | $467.74 | $524.81 | $676.08 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $9,120.11 | Facility | None | $691.83 | $1,348.96 | $9,120.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $707.95 | Professional | None | $371.54 | $549.54 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,348.96 Typical High $1,995.26 | Facility | None | $602.56 | $1,348.96 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $912.01 | Professional | None | $478.63 | $630.96 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $676.08 Typical High $1,479.11 | Facility | None | $478.63 | $676.08 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $831.76 | Professional | None | $588.84 | $676.08 | $831.76 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $478.63 Typical High $812.83 | Professional | None | $79.43 | $478.63 | $812.83 |
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 $346.74 Median $537.03 Typical High $870.96 | Professional | None | $346.74 | $537.03 | $870.96 |
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 $239.88 Median $251.19 Typical High $338.84 | Professional | 52 · Reduced service | $239.88 | $251.19 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $134.90 | Professional | 53 · Discontinued | $95.50 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $371.54 Typical High $501.19 | Professional | 54 · Surgery only | $354.81 | $371.54 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $100.00 | Professional | 55 · Aftercare only | $72.44 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $67.61 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $346.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $331.13 | $346.74 | $467.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,230.27 Typical High $1,548.82 | Professional | 50 · Both sides | $870.96 | $1,230.27 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $288.40 Median $416.87 Typical High $524.81 | Professional | 51 · Multiple procedures | $288.40 | $416.87 | $524.81 |
Where South Carolina sits
The same service costs 4.4 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 $6,491MT $1,489
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.