How much rates vary
Facilitymedian $4,365 · 10th to 90th $490 to $22,387Professionalmedian $5,495 · 10th to 90th $617 to $10,471
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 $691.83 Median $8,709.64 Typical High $21,877.62 | Facility | None | $691.83 | $8,709.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $5,495.41 Typical High $7,413.10 | Professional | None | $562.34 | $5,495.41 | $7,413.10 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $2,691.53 Typical High $6,918.31 | Facility | None | $489.78 | $2,691.53 | $6,918.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $436.52 Median $1,122.02 Typical High $5,495.41 | Professional | None | $436.52 | $1,122.02 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $13,489.63 Typical High $22,387.21 | Facility | None | $602.56 | $13,489.63 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,445.44 Typical High $10,232.93 | Professional | None | $616.60 | $1,445.44 | $10,232.93 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $7,413.10 Typical High $13,803.84 | Facility | None | $691.83 | $7,413.10 | $13,803.84 |
Medcost Setting Professional Modifier None Typical Low $7,079.46 Median $8,709.64 Typical High $9,549.93 | Professional | None | $7,079.46 | $8,709.64 | $9,549.93 |
Molina Setting Professional Modifier None Typical Low $5,623.41 Median $8,317.64 Typical High $11,220.18 | Professional | None | $5,623.41 | $8,317.64 | $11,220.18 |
United Setting Facility Modifier None Typical Low $5,623.41 Median $20,892.96 Typical High $43,651.58 | Facility | None | $5,623.41 | $20,892.96 | $43,651.58 |
United Setting Professional Modifier None Typical Low $512.86 Median $4,897.79 Typical High $12,589.25 | Professional | None | $512.86 | $4,897.79 | $12,589.25 |
5 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 $309.03 Median $389.05 Typical High $3,630.78 | Professional | 52 · Reduced service | $309.03 | $389.05 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $154.88 Typical High $1,479.11 | Professional | 53 · Discontinued | $123.03 | $154.88 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $588.84 Typical High $5,495.41 | Professional | 54 · Surgery only | $457.09 | $588.84 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $117.49 Typical High $1,096.48 | Professional | 55 · Aftercare only | $91.20 | $117.49 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $77.62 Typical High $741.31 | Professional | 56 · Pre-op care only | $61.66 | $77.62 | $741.31 |
Where South Carolina sits
The same service costs 6.1 times more in Alaska than in Vermont. 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 $33,081VT $5,424
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.