How much rates vary
Facilitymedian $302 · 10th to 90th $98 to $1,660Professionalmedian $132 · 10th to 90th $95 to $186
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 $107.15 Median $4,265.80 Typical High $16,595.87 | Facility | None | $107.15 | $4,265.80 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $141.25 | Professional | None | $104.71 | $112.20 | $141.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $251.19 Median $416.87 Typical High $758.58 | Facility | None | $251.19 | $416.87 | $758.58 |
BCBS South Carolina Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $169.82 | Professional | None | $95.50 | $144.54 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $114.82 Typical High $181.97 | Facility | None | $75.86 | $114.82 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $194.98 | Professional | None | $97.72 | $120.23 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $120.23 Typical High $154.88 | Facility | None | $87.10 | $120.23 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $204.17 | Professional | None | $128.82 | $144.54 | $204.17 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $204.17 | Professional | None | $102.33 | $138.04 | $204.17 |
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 $77.62 Median $112.20 Typical High $181.97 | Professional | None | $77.62 | $112.20 | $181.97 |
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 $53.70 Median $53.70 Typical High $70.79 | Professional | 52 · Reduced service | $53.70 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $28.18 | Professional | 53 · Discontinued | $21.38 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | 54 · Surgery only | $79.43 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $21.38 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $74.13 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $74.13 | $74.13 | $100.00 |
Ambetter Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 54 · Surgery only | $102.33 | $102.33 | $102.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $81.28 Typical High $109.65 | Professional | 51 · Multiple procedures | $64.57 | $81.28 | $109.65 |
Where South Carolina sits
The same service costs 13.1 times more in Hawaii than in Maryland. 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
HI $2,944MD $224
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.