How much rates vary
Facilitymedian $30,903 · 10th to 90th $3,020 to $144,544Professionalmedian $933 · 10th to 90th $71 to $1,549
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 $1,258.93 Median $14,791.08 Typical High $87,096.36 | Facility | None | $1,258.93 | $14,791.08 | $87,096.36 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,995.26 | Professional | None | $891.25 | $1,258.93 | $1,995.26 |
Ambetter Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,715.35 Median $42,657.95 Typical High $169,824.37 | Facility | None | $3,715.35 | $42,657.95 | $169,824.37 |
BCBS South Carolina Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $1,995.26 | Professional | None | $758.58 | $1,230.27 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $27,542.29 Typical High $44,668.36 | Facility | None | $602.56 | $27,542.29 | $44,668.36 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,174.90 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $36,307.81 Typical High $48,977.88 | Facility | None | $1,000.00 | $36,307.81 | $48,977.88 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,412.54 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $831.76 Typical High $1,412.54 | Professional | None | $66.07 | $831.76 | $1,412.54 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $31,622.78 Typical High $77,624.71 | Facility | None | $3,019.95 | $31,622.78 | $77,624.71 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $2,238.72 | Professional | None | $891.25 | $1,348.96 | $2,238.72 |
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 $446.68 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $446.68 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $177.83 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $676.08 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $134.90 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $89.13 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $630.96 | $870.96 | $870.96 |
Where South Carolina sits
The same service costs 19.9 times more in Alaska 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
AK $53,750MT $2,699
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.