How much rates vary
Facilitymedian $1,318 · 10th to 90th $661 to $11,482Professionalmedian $724 · 10th to 90th $102 to $1,230
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 $251.19 Median $5,623.41 Typical High $21,877.62 | Facility | None | $251.19 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $446.68 Typical High $1,047.13 | Professional | None | $218.78 | $446.68 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $295.12 Typical High $295.12 | Professional | None | $67.61 | $295.12 | $295.12 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $891.25 Typical High $10,232.93 | Facility | None | $676.08 | $891.25 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $776.25 | Professional | None | $158.49 | $263.03 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $3,715.35 | Facility | None | $602.56 | $2,290.87 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $512.86 Typical High $1,412.54 | Professional | None | $223.87 | $512.86 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $676.08 Typical High $1,479.11 | Facility | None | $251.19 | $676.08 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,174.90 | Professional | None | $870.96 | $1,000.00 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $776.25 Typical High $1,258.93 | Professional | None | $81.28 | $776.25 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $190.55 Median $602.56 Typical High $1,445.44 | Professional | None | $190.55 | $602.56 | $1,445.44 |
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 $109.65 Median $141.25 Typical High $524.81 | Professional | 52 · Reduced service | $109.65 | $141.25 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $56.23 Typical High $213.80 | Professional | 53 · Discontinued | $44.67 | $56.23 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $208.93 Typical High $794.33 | Professional | 54 · Surgery only | $165.96 | $208.93 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $41.69 Typical High $158.49 | Professional | 55 · Aftercare only | $33.11 | $41.69 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $28.18 Typical High $104.71 | Professional | 56 · Pre-op care only | $22.39 | $28.18 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $194.98 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $154.88 | $194.98 | $741.31 |
Where South Carolina sits
The same service costs 5.1 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 $7,315MT $1,443
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.