How much rates vary
Facilitymedian $1,820 · 10th to 90th $741 to $10,233Professionalmedian $417 · 10th to 90th $93 to $631
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 $371.54 Median $9,120.11 Typical High $21,877.62 | Facility | None | $371.54 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $549.54 | Professional | None | $363.08 | $436.52 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $8,912.51 | Facility | None | $851.14 | $2,818.38 | $8,912.51 |
BCBS South Carolina Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $512.86 | Professional | None | $295.12 | $446.68 | $512.86 |
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 $371.54 Median $489.78 Typical High $741.31 | Professional | None | $371.54 | $489.78 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $645.65 Typical High $1,318.26 | Facility | None | $363.08 | $645.65 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $645.65 | Professional | None | $467.74 | $549.54 | $645.65 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $363.08 Typical High $630.96 | Professional | None | $38.90 | $363.08 | $630.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $707.95 | Professional | None | $275.42 | $426.58 | $707.95 |
7 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 $204.17 Typical High $275.42 | Professional | 52 · Reduced service | $186.21 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $109.65 | Professional | 53 · Discontinued | $74.13 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $416.87 | Professional | 54 · Surgery only | $275.42 | $309.03 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $83.18 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $54.95 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $389.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $295.12 Typical High $426.58 | Professional | 51 · Multiple procedures | $234.42 | $295.12 | $426.58 |
Where South Carolina sits
The same service costs 11.0 times more in Vermont 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
VT $12,892MT $1,170
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.