How much rates vary
Facilitymedian $1,862 · 10th to 90th $661 to $11,220Professionalmedian $324 · 10th to 90th $219 to $479
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 $302.00 Median $5,888.44 Typical High $21,877.62 | Facility | None | $302.00 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $323.59 | Professional | None | $239.88 | $302.00 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $2,041.74 Typical High $10,715.19 | Facility | None | $691.83 | $2,041.74 | $10,715.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $204.17 Median $426.58 Typical High $549.54 | Professional | None | $204.17 | $426.58 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,570.40 | Facility | None | $602.56 | $1,862.09 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $512.86 | Professional | None | $263.03 | $302.00 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $676.08 Typical High $1,479.11 | Facility | None | $281.84 | $676.08 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $602.56 | Professional | None | $281.84 | $354.81 | $602.56 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $457.09 | Professional | None | $223.87 | $331.13 | $457.09 |
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 $234.42 Median $302.00 Typical High $501.19 | Professional | None | $234.42 | $302.00 | $501.19 |
6 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 $120.23 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $120.23 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $48.98 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $181.97 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $36.31 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.99 | $30.20 | $30.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $204.17 Typical High $295.12 | Professional | 51 · Multiple procedures | $158.49 | $204.17 | $295.12 |
Where South Carolina sits
The same service costs 8.5 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 $6,252MT $735
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.