How much rates vary
Facilitymedian $1,622 · 10th to 90th $661 to $10,715Professionalmedian $407 · 10th to 90th $52 to $692
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 $512.86 Median $5,888.44 Typical High $21,877.62 | Facility | None | $512.86 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $512.86 | Professional | None | $416.87 | $512.86 | $512.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,548.82 Typical High $10,232.93 | Facility | None | $691.83 | $1,548.82 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $562.34 | Professional | None | $338.84 | $371.54 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $2,290.87 | Facility | None | $602.56 | $1,621.81 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $870.96 | Professional | None | $457.09 | $478.63 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $1,479.11 | Facility | None | $512.86 | $676.08 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $660.69 | Professional | None | $467.74 | $537.03 | $660.69 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $354.81 Typical High $691.83 | Professional | None | $46.77 | $354.81 | $691.83 |
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 $398.11 Median $524.81 Typical High $870.96 | Professional | None | $398.11 | $524.81 | $870.96 |
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 $208.93 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $208.93 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $83.18 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $316.23 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $63.10 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $41.69 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $295.12 | $354.81 | $354.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $288.40 Typical High $407.38 | Professional | 51 · Multiple procedures | $234.42 | $288.40 | $407.38 |
Where South Carolina sits
The same service costs 4.1 times more in Oklahoma 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
OK $5,653MT $1,368
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.