How much rates vary
Facilitymedian $871 · 10th to 90th $603 to $4,266Professionalmedian $275 · 10th to 90th $174 to $417
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 $234.42 Median $5,888.44 Typical High $21,877.62 | Facility | None | $234.42 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $338.84 | Professional | None | $194.98 | $234.42 | $338.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $870.96 Typical High $3,388.44 | Facility | None | $676.08 | $870.96 | $3,388.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $173.78 Median $316.23 Typical High $346.74 | Professional | None | $173.78 | $316.23 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,621.81 | Facility | None | $602.56 | $1,000.00 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $524.81 | Professional | None | $234.42 | $281.84 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $457.09 | Professional | None | $346.74 | $371.54 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $588.84 Typical High $1,122.02 | Facility | None | $234.42 | $588.84 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $346.74 | Professional | None | $223.87 | $331.13 | $346.74 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $323.59 | Professional | None | $162.18 | $204.17 | $323.59 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $478.63 | Professional | None | $177.83 | $251.19 | $478.63 |
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 $97.72 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $97.72 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $38.90 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $144.54 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $29.51 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.50 | $23.44 | $23.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $165.96 Typical High $173.78 | Professional | 51 · Multiple procedures | $141.25 | $165.96 | $173.78 |
Where South Carolina sits
The same service costs 6.8 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 $4,179MT $618
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.