How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,514 to $16,596Professionalmedian $1,023 · 10th to 90th $661 to $1,585
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 $10,964.78 Typical High $21,877.62 | Facility | None | $1,258.93 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,258.93 | Professional | None | $912.01 | $1,258.93 | $1,258.93 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $4,073.80 Typical High $13,489.63 | Facility | None | $1,905.46 | $4,073.80 | $13,489.63 |
BCBS South Carolina Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,659.59 | Professional | None | $812.83 | $977.24 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $4,897.79 | Facility | None | $602.56 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,202.26 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,412.54 Typical High $2,511.89 | Facility | None | $891.25 | $1,412.54 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,513.56 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $1,047.13 Typical High $1,584.89 | Professional | None | $66.07 | $1,047.13 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $2,290.87 | Professional | None | $912.01 | $1,348.96 | $2,290.87 |
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 $457.09 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $457.09 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $181.97 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $691.83 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $138.04 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $91.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $645.65 | $891.25 | $891.25 |
Where South Carolina sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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 $11,128KY $2,365
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.