How much rates vary
Facilitymedian $8,318 · 10th to 90th $2,818 to $36,308Professionalmedian $4,571 · 10th to 90th $501 to $7,943
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 $588.84 Median $8,709.64 Typical High $20,417.38 | Facility | None | $588.84 | $8,709.64 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $4,265.80 Typical High $6,309.57 | Professional | None | $478.63 | $4,265.80 | $6,309.57 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,630.78 Median $10,471.29 Typical High $38,018.94 | Facility | None | $3,630.78 | $10,471.29 | $38,018.94 |
BCBS South Carolina Setting Professional Modifier None Typical Low $363.08 Median $1,071.52 Typical High $5,370.32 | Professional | None | $363.08 | $1,071.52 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $7,413.10 Typical High $10,471.29 | Facility | None | $602.56 | $7,413.10 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $1,096.48 Typical High $8,317.64 | Professional | None | $575.44 | $1,096.48 | $8,317.64 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $6,309.57 Typical High $8,912.51 | Facility | None | $588.84 | $6,309.57 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $7,244.36 | Professional | None | $5,888.44 | $5,888.44 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $4,168.69 Median $6,309.57 Typical High $8,317.64 | Professional | None | $4,168.69 | $6,309.57 | $8,317.64 |
United Setting Facility Modifier None Typical Low $3,311.31 Median $11,220.18 Typical High $33,884.42 | Facility | None | $3,311.31 | $11,220.18 | $33,884.42 |
United Setting Professional Modifier None Typical Low $446.68 Median $3,890.45 Typical High $8,511.38 | Professional | None | $446.68 | $3,890.45 | $8,511.38 |
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 $257.04 Median $331.13 Typical High $3,162.28 | Professional | 52 · Reduced service | $257.04 | $331.13 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $131.83 Typical High $1,258.93 | Professional | 53 · Discontinued | $102.33 | $131.83 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $489.78 Typical High $4,786.30 | Professional | 54 · Surgery only | $389.05 | $489.78 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $97.72 Typical High $954.99 | Professional | 55 · Aftercare only | $77.62 | $97.72 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $66.07 Typical High $630.96 | Professional | 56 · Pre-op care only | $51.29 | $66.07 | $630.96 |
Where South Carolina sits
The same service costs 4.3 times more in Alabama than in Maine. 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 $20,420ME $4,758
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.