How much rates vary
Facilitymedian $525 · 10th to 90th $151 to $1,096Professionalmedian $302 · 10th to 90th $95 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 $331.13 Median $4,897.79 Typical High $21,877.62 | Facility | None | $331.13 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $436.52 | Professional | None | $295.12 | $331.13 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
BCBS South Carolina Setting Facility Modifier None Typical Low $302.00 Median $575.44 Typical High $794.33 | Facility | None | $302.00 | $575.44 | $794.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $354.81 | Professional | None | $234.42 | $281.84 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $371.54 Typical High $707.95 | Facility | None | $151.36 | $371.54 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $524.81 | Professional | None | $288.40 | $323.59 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $398.11 Typical High $630.96 | Facility | None | $95.50 | $398.11 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $436.52 | Professional | None | $302.00 | $363.08 | $436.52 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $263.03 Typical High $457.09 | Professional | None | $38.90 | $263.03 | $457.09 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $478.63 | Professional | None | $234.42 | $302.00 | $478.63 |
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 $151.36 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $151.36 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $72.44 | Professional | 53 · Discontinued | $60.26 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $245.47 Typical High $269.15 | Professional | 54 · Surgery only | $229.09 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $50.12 Typical High $53.70 | Professional | 55 · Aftercare only | $45.71 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $36.31 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $234.42 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $213.80 | $234.42 | $251.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $645.65 Typical High $831.76 | Professional | 50 · Both sides | $457.09 | $645.65 | $831.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $151.36 Median $218.78 Typical High $275.42 | Professional | 51 · Multiple procedures | $151.36 | $218.78 | $275.42 |
Where South Carolina sits
The same service costs 6.5 times more in Connecticut than in Maryland. 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
CT $3,149MD $483
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.