How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,318 to $11,749Professionalmedian $1,318 · 10th to 90th $151 to $2,188
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 $1,819.70 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,819.70 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,819.70 | $1,819.70 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $7,079.46 | Facility | None | $3,235.94 | $5,011.87 | $7,079.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,174.90 | $1,949.84 |
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 $1,412.54 Median $1,584.89 Typical High $3,019.95 | Professional | None | $1,412.54 | $1,584.89 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $7,079.46 | Facility | None | $1,148.15 | $1,819.70 | $7,079.46 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,737.80 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,318.26 Typical High $2,187.76 | Professional | None | $123.03 | $1,318.26 | $2,187.76 |
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 $1,288.25 Median $1,819.70 Typical High $3,235.94 | Professional | None | $1,288.25 | $1,819.70 | $3,235.94 |
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 $645.65 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $645.65 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $257.04 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $954.99 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $194.98 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $128.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $891.25 | $1,258.93 | $1,258.93 |
Where South Carolina sits
The same service costs 6.6 times more in Alabama 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
AL $18,462KY $2,797
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.