How much rates vary
Facilitymedian $794 · 10th to 90th $468 to $3,890Professionalmedian $316 · 10th to 90th $155 to $457
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 $181.97 Median $4,897.79 Typical High $21,877.62 | Facility | None | $181.97 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $371.54 | Professional | None | $169.82 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $74.13 Typical High $186.21 | Professional | 53 · Discontinued | $36.31 | $74.13 | $186.21 |
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 $501.19 Median $794.33 Typical High $2,884.03 | Facility | None | $501.19 | $794.33 | $2,884.03 |
BCBS South Carolina Setting Professional Modifier None Typical Low $134.90 Median $331.13 Typical High $363.08 | Professional | None | $134.90 | $331.13 | $363.08 |
BCBS South Carolina Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $67.61 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $575.44 Typical High $912.01 | Facility | None | $457.09 | $575.44 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $338.84 Typical High $446.68 | Professional | None | $173.78 | $338.84 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $741.31 | Professional | None | $426.58 | $457.09 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $426.58 Typical High $645.65 | Facility | None | $181.97 | $426.58 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $512.86 | Professional | None | $354.81 | $407.38 | $512.86 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $309.03 Typical High $602.56 | Professional | None | $162.18 | $309.03 | $602.56 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $478.63 | Professional | None | $147.91 | $269.15 | $478.63 |
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 $91.20 Median $154.88 Typical High $186.21 | Professional | 52 · Reduced service | $91.20 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $218.78 Typical High $275.42 | Professional | 54 · Surgery only | $134.90 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $43.65 Typical High $54.95 | Professional | 55 · Aftercare only | $26.92 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $28.84 Typical High $37.15 | Professional | 56 · Pre-op care only | $17.78 | $28.84 | $37.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $218.78 Typical High $275.42 | Professional | 51 · Multiple procedures | $204.17 | $218.78 | $275.42 |
Where South Carolina sits
The same service costs 4.7 times more in Connecticut than in North Dakota. 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
CT $3,190ND $672
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.