How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,230 to $13,183Professionalmedian $646 · 10th to 90th $107 to $1,122
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 $794.33 Median $10,000.00 Typical High $22,908.68 | Facility | None | $794.33 | $10,000.00 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,096.48 | Professional | None | $691.83 | $794.33 | $1,096.48 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $676.08 Typical High $1,122.02 | Professional | None | $338.84 | $676.08 | $1,122.02 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $3,630.78 Typical High $11,481.54 | Facility | None | $1,698.24 | $3,630.78 | $11,481.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $616.60 Median $1,000.00 Typical High $1,348.96 | Professional | None | $616.60 | $1,000.00 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,511.89 | Facility | None | $602.56 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,230.27 | Professional | None | $794.33 | $794.33 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $2,137.96 | Facility | None | $616.60 | $794.33 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,778.28 | Professional | None | $794.33 | $933.25 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $478.63 Typical High $812.83 | Professional | None | $79.43 | $478.63 | $812.83 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,548.13 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,548.13 | $18,197.01 |
United Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,174.90 | Professional | None | $562.34 | $724.44 | $1,174.90 |
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 $338.84 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $67.61 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $549.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,479.11 Typical High $2,630.27 | Professional | 50 · Both sides | $1,258.93 | $1,479.11 | $2,630.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $489.78 Typical High $870.96 | Professional | 51 · Multiple procedures | $416.87 | $489.78 | $870.96 |
Where South Carolina sits
The same service costs 3.6 times more in Wisconsin 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
WI $7,904MT $2,218
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.