How much rates vary
Facilitymedian $794 · 10th to 90th $155 to $2,089Professionalmedian $398 · 10th to 90th $49 to $603
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 $446.68 Median $4,365.16 Typical High $16,595.87 | Facility | None | $446.68 | $4,365.16 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $446.68 | Professional | None | $380.19 | $446.68 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
BCBS South Carolina Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,089.30 | Facility | None | $457.09 | $794.33 | $2,089.30 |
BCBS South Carolina Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $501.19 | Professional | None | $323.59 | $426.58 | $501.19 |
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 $398.11 Median $398.11 Typical High $707.95 | Professional | None | $398.11 | $398.11 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $446.68 Typical High $630.96 | Facility | None | $81.28 | $446.68 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $616.60 | Professional | None | $426.58 | $467.74 | $616.60 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $346.74 Typical High $616.60 | Professional | None | $38.90 | $346.74 | $616.60 |
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 $309.03 Median $389.05 Typical High $630.96 | Professional | None | $309.03 | $389.05 | $630.96 |
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 $186.21 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $186.21 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $281.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $56.23 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.02 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $263.03 | $316.23 | $316.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $741.31 Typical High $1,047.13 | Professional | 50 · Both sides | $630.96 | $741.31 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $213.80 Median $245.47 Typical High $346.74 | Professional | 51 · Multiple procedures | $213.80 | $245.47 | $346.74 |
Where South Carolina sits
The same service costs 6.4 times more in Connecticut than in Texas. 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 $3,322TX $515
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.