How much rates vary
Facilitymedian $2,042 · 10th to 90th $776 to $13,490Professionalmedian $501 · 10th to 90th $93 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 $602.56 Median $10,000.00 Typical High $21,877.62 | Facility | None | $602.56 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $616.60 | Professional | None | $524.81 | $602.56 | $616.60 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,235.94 Typical High $12,589.25 | Facility | None | $851.14 | $3,235.94 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $870.96 | Professional | None | $478.63 | $707.95 | $870.96 |
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 $630.96 Median $660.69 Typical High $977.24 | Professional | None | $630.96 | $660.69 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $741.31 Typical High $1,698.24 | Facility | None | $602.56 | $741.31 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,148.15 | Professional | None | $602.56 | $707.95 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $389.05 Typical High $660.69 | Professional | None | $79.43 | $389.05 | $660.69 |
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 $446.68 Median $562.34 Typical High $954.99 | Professional | None | $446.68 | $562.34 | $954.99 |
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 $263.03 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $263.03 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $104.71 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $389.05 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $52.48 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $363.08 | $426.58 | $426.58 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,148.15 Typical High $1,737.80 | Professional | 50 · Both sides | $1,000.00 | $1,148.15 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $338.84 Median $389.05 Typical High $575.44 | Professional | 51 · Multiple procedures | $338.84 | $389.05 | $575.44 |
Where South Carolina sits
The same service costs 4.3 times more in Wisconsin 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
WI $7,406MT $1,722
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.