How much rates vary
Facilitymedian $4,266 · 10th to 90th $126 to $21,878Professionalmedian $589 · 10th to 90th $155 to $1,047
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 $199.53 Median $7,762.47 Typical High $23,442.29 | Facility | None | $199.53 | $7,762.47 | $23,442.29 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $588.84 Typical High $794.33 | Professional | None | $162.18 | $588.84 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
BCBS South Carolina Setting Facility Modifier None Typical Low $7,079.46 Median $16,982.44 Typical High $23,988.33 | Facility | None | $7,079.46 | $16,982.44 | $23,988.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $123.03 Median $281.84 Typical High $616.60 | Professional | None | $123.03 | $281.84 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $2,290.87 | Facility | None | $588.84 | $851.14 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $457.09 Typical High $1,174.90 | Professional | None | $154.88 | $457.09 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $389.05 Typical High $1,071.52 | Facility | None | $151.36 | $389.05 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,071.52 | Professional | None | $660.69 | $954.99 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,071.52 | Professional | None | $549.54 | $794.33 | $1,071.52 |
United Setting Facility Modifier None Typical Low $83.18 Median $426.58 Typical High $2,238.72 | Facility | None | $83.18 | $426.58 | $2,238.72 |
United Setting Professional Modifier None Typical Low $144.54 Median $537.03 Typical High $1,348.96 | Professional | None | $144.54 | $537.03 | $1,348.96 |
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 $87.10 Median $112.20 Typical High $398.11 | Professional | 52 · Reduced service | $87.10 | $112.20 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $44.67 Typical High $162.18 | Professional | 53 · Discontinued | $35.48 | $44.67 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $165.96 Typical High $602.56 | Professional | 54 · Surgery only | $131.83 | $165.96 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $120.23 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $79.43 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $79.43 |
Where South Carolina sits
The same service costs 17.4 times more in Alabama 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
AL $9,157MT $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.