How much rates vary
Facilitymedian $3,236 · 10th to 90th $759 to $11,220Professionalmedian $575 · 10th to 90th $407 to $794
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 $562.34 Median $9,772.37 Typical High $21,877.62 | Facility | None | $562.34 | $9,772.37 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $562.34 | Professional | None | $467.74 | $562.34 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | None | $407.38 | $446.68 | $446.68 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,715.35 Typical High $10,715.19 | Facility | None | $851.14 | $3,715.35 | $10,715.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $691.83 | Professional | None | $407.38 | $616.60 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,073.80 Typical High $6,025.60 | Facility | None | $602.56 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $831.76 | Professional | None | $575.44 | $630.96 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $724.44 Typical High $1,348.96 | Facility | None | $562.34 | $724.44 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $691.83 | Professional | None | $549.54 | $676.08 | $691.83 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $812.83 | Professional | None | $416.87 | $537.03 | $812.83 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $977.24 | Professional | None | $407.38 | $501.19 | $977.24 |
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 $234.42 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $234.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $93.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $354.81 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $70.79 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $46.77 | $56.23 | $56.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $338.84 Median $338.84 Typical High $363.08 | Professional | 51 · Multiple procedures | $338.84 | $338.84 | $363.08 |
Where South Carolina sits
The same service costs 5.9 times more in Alaska 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
AK $8,723MT $1,483
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.