How much rates vary
Facilitymedian $5,248 · 10th to 90th $933 to $19,498Professionalmedian $525 · 10th to 90th $105 to $759
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 $645.65 Median $9,120.11 Typical High $20,417.38 | Facility | None | $645.65 | $9,120.11 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $851.14 | Professional | None | $549.54 | $645.65 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,096.48 Median $6,165.95 Typical High $18,197.01 | Facility | None | $1,096.48 | $6,165.95 | $18,197.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $707.95 | Professional | None | $512.86 | $549.54 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $7,244.36 | Facility | None | $630.96 | $2,951.21 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $977.24 | Professional | None | $562.34 | $616.60 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $912.01 Typical High $4,265.80 | Facility | None | $602.56 | $912.01 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $645.65 Typical High $758.58 | Professional | None | $630.96 | $645.65 | $758.58 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $416.87 Typical High $724.44 | Professional | None | $79.43 | $416.87 | $724.44 |
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 $457.09 Median $562.34 Typical High $891.25 | Professional | None | $457.09 | $562.34 | $891.25 |
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 $275.42 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $275.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $109.65 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $416.87 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $54.95 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $389.05 | $446.68 | $446.68 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $331.13 Typical High $501.19 | Professional | 51 · Multiple procedures | $316.23 | $331.13 | $501.19 |
Where South Carolina sits
The same service costs 7.5 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 $13,659MT $1,825
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.