How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,288 to $17,783Professionalmedian $617 · 10th to 90th $95 to $955
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 $741.31 Median $9,120.11 Typical High $22,908.68 | Facility | None | $741.31 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $758.58 | Professional | None | $630.96 | $741.31 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,548.82 Median $3,630.78 Typical High $14,125.38 | Facility | None | $1,548.82 | $3,630.78 | $14,125.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,023.29 | Professional | None | $575.44 | $831.76 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,511.89 | Facility | None | $602.56 | $1,862.09 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,174.90 | Professional | None | $776.25 | $776.25 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $812.83 Typical High $1,778.28 | Facility | None | $588.84 | $812.83 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,096.48 | Professional | None | $741.31 | $912.01 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $489.78 Typical High $831.76 | Professional | None | $79.43 | $489.78 | $831.76 |
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 $537.03 Median $691.83 Typical High $1,122.02 | Professional | None | $537.03 | $691.83 | $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 $316.23 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $125.89 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $63.10 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $512.86 | $512.86 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,412.54 Typical High $1,698.24 | Professional | 50 · Both sides | $1,230.27 | $1,412.54 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $478.63 Typical High $575.44 | Professional | 51 · Multiple procedures | $407.38 | $478.63 | $575.44 |
Where South Carolina sits
The same service costs 7.6 times more in Oklahoma 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
OK $11,248TX $1,472
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.