How much rates vary
Facilitymedian $2,399 · 10th to 90th $741 to $10,471Professionalmedian $501 · 10th to 90th $105 to $741
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 $416.87 Median $9,120.11 Typical High $21,877.62 | Facility | None | $416.87 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $616.60 | Professional | None | $416.87 | $524.81 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,311.31 Typical High $8,912.51 | Facility | None | $851.14 | $3,311.31 | $8,912.51 |
BCBS South Carolina Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $616.60 | Professional | None | $338.84 | $537.03 | $616.60 |
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 $426.58 Median $575.44 Typical High $831.76 | Professional | None | $426.58 | $575.44 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $416.87 Median $660.69 Typical High $1,479.11 | Facility | None | $416.87 | $660.69 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $724.44 | Professional | None | $549.54 | $616.60 | $724.44 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $426.58 Typical High $741.31 | Professional | None | $79.43 | $426.58 | $741.31 |
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 $316.23 Median $489.78 Typical High $831.76 | Professional | None | $316.23 | $489.78 | $831.76 |
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 $208.93 Median $229.09 Typical High $309.03 | Professional | 52 · Reduced service | $208.93 | $229.09 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $123.03 | Professional | 53 · Discontinued | $83.18 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $346.74 Typical High $457.09 | Professional | 54 · Surgery only | $309.03 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $69.18 Typical High $91.20 | Professional | 55 · Aftercare only | $61.66 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $61.66 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $323.59 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $288.40 | $323.59 | $426.58 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,023.29 Typical High $1,412.54 | Professional | 50 · Both sides | $812.83 | $1,023.29 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $338.84 Typical High $478.63 | Professional | 51 · Multiple procedures | $275.42 | $338.84 | $478.63 |
Where South Carolina sits
The same service costs 6.4 times more in Alaska 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
AK $8,723MT $1,361
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.