How much rates vary
Facilitymedian $1,047 · 10th to 90th $603 to $4,898Professionalmedian $214 · 10th to 90th $148 to $288
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 $204.17 Median $5,888.44 Typical High $21,877.62 | Facility | None | $204.17 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | None | $173.78 | $204.17 | $204.17 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,202.26 Typical High $4,265.80 | Facility | None | $676.08 | $1,202.26 | $4,265.80 |
BCBS South Carolina Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $331.13 | Professional | None | $147.91 | $251.19 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $1,513.56 | Facility | None | $602.56 | $954.99 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $363.08 | Professional | None | $190.55 | $213.80 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $588.84 Typical High $1,047.13 | Facility | None | $204.17 | $588.84 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $281.84 | Professional | None | $194.98 | $234.42 | $281.84 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $257.04 | Professional | None | $131.83 | $181.97 | $257.04 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $363.08 | Professional | None | $165.96 | $208.93 | $363.08 |
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 $85.11 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $34.67 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $25.70 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.38 | $20.42 | $20.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $120.23 Typical High $165.96 | Professional | 51 · Multiple procedures | $114.82 | $120.23 | $165.96 |
Where South Carolina sits
The same service costs 9.2 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 $4,822MT $526
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.