How much rates vary
Facilitymedian $4,169 · 10th to 90th $813 to $19,953Professionalmedian $646 · 10th to 90th $98 to $933
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 $812.83 Median $9,772.37 Typical High $21,877.62 | Facility | None | $812.83 | $9,772.37 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $912.01 | Professional | None | $691.83 | $812.83 | $912.01 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $4,786.30 Typical High $18,620.87 | Facility | None | $851.14 | $4,786.30 | $18,620.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $851.14 | Professional | None | $645.65 | $676.08 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $5,623.41 | Facility | None | $602.56 | $2,398.83 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,288.25 | Professional | None | $691.83 | $776.25 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $812.83 Typical High $2,691.53 | Facility | None | $616.60 | $812.83 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $954.99 | Professional | None | $724.44 | $812.83 | $954.99 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $512.86 Typical High $870.96 | Professional | None | $79.43 | $512.86 | $870.96 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,122.02 | Professional | None | $588.84 | $724.44 | $1,122.02 |
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 $346.74 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $346.74 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $524.81 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $104.71 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $69.18 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $575.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,258.93 Typical High $1,905.46 | Professional | 50 · Both sides | $1,071.52 | $1,258.93 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $416.87 Typical High $630.96 | Professional | 51 · Multiple procedures | $363.08 | $416.87 | $630.96 |
Where South Carolina sits
The same service costs 6.1 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 $14,160MT $2,323
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.