How much rates vary
Facilitymedian $1,862 · 10th to 90th $741 to $10,233Professionalmedian $501 · 10th to 90th $93 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 $407.38 Median $9,120.11 Typical High $21,877.62 | Facility | None | $407.38 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $602.56 | Professional | None | $398.11 | $512.86 | $602.56 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,884.03 Typical High $9,120.11 | Facility | None | $851.14 | $2,884.03 | $9,120.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $676.08 | Professional | None | $331.13 | $512.86 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,511.89 | Facility | None | $602.56 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $831.76 | Professional | None | $426.58 | $602.56 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $660.69 Typical High $1,698.24 | Facility | None | $407.38 | $660.69 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $794.33 | Professional | None | $602.56 | $630.96 | $794.33 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $426.58 Typical High $741.31 | Professional | None | $38.90 | $426.58 | $741.31 |
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 $316.23 Median $489.78 Typical High $831.76 | Professional | None | $316.23 | $489.78 | $831.76 |
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 $204.17 Median $234.42 Typical High $302.00 | Professional | 52 · Reduced service | $204.17 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $93.33 Typical High $120.23 | Professional | 53 · Discontinued | $81.28 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $346.74 Typical High $457.09 | Professional | 54 · Surgery only | $309.03 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $69.18 Typical High $91.20 | Professional | 55 · Aftercare only | $61.66 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $46.77 Typical High $60.26 | Professional | 56 · Pre-op care only | $40.74 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $323.59 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $288.40 | $323.59 | $426.58 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,148.15 Typical High $1,412.54 | Professional | 50 · Both sides | $954.99 | $1,148.15 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $380.19 Typical High $467.74 | Professional | 51 · Multiple procedures | $316.23 | $380.19 | $467.74 |
Where South Carolina sits
The same service costs 4.7 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 $6,438MT $1,383
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.