How much rates vary
Facilitymedian $1,905 · 10th to 90th $676 to $13,183Professionalmedian $631 · 10th to 90th $95 to $1,072
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 $758.58 Median $5,888.44 Typical High $21,877.62 | Facility | None | $758.58 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $758.58 | Professional | None | $645.65 | $758.58 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,905.46 Typical High $12,589.25 | Facility | None | $691.83 | $1,905.46 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $1,096.48 | Professional | None | $588.84 | $831.76 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,511.89 | Facility | None | $602.56 | $1,778.28 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,174.90 | Professional | None | $812.83 | $812.83 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $758.58 Typical High $1,778.28 | Facility | None | $588.84 | $758.58 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,047.13 | Professional | None | $758.58 | $870.96 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $489.78 Typical High $851.14 | Professional | None | $79.43 | $489.78 | $851.14 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,202.26 | Professional | None | $549.54 | $691.83 | $1,202.26 |
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 $323.59 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $524.81 | $524.81 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,412.54 Typical High $1,819.70 | Professional | 50 · Both sides | $1,230.27 | $1,412.54 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $467.74 Typical High $602.56 | Professional | 51 · Multiple procedures | $416.87 | $467.74 | $602.56 |
Where South Carolina sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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
WI $7,283HI $2,091
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.