How much rates vary
Facilitymedian $871 · 10th to 90th $490 to $6,166Professionalmedian $398 · 10th to 90th $72 to $617
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 $501.19 Median $5,623.41 Typical High $21,877.62 | Facility | None | $501.19 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $501.19 | Professional | None | $416.87 | $501.19 | $501.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $5,754.40 | Facility | None | $512.86 | $870.96 | $5,754.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $398.11 | Professional | None | $316.23 | $389.05 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $1,174.90 | Facility | None | $457.09 | $741.31 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $691.83 | Professional | None | $380.19 | $407.38 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $977.24 | Professional | None | $416.87 | $446.68 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $537.03 Typical High $1,122.02 | Facility | None | $407.38 | $537.03 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $616.60 | Professional | None | $371.54 | $489.78 | $616.60 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $346.74 Typical High $630.96 | Professional | None | $54.95 | $346.74 | $630.96 |
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 $346.74 Median $416.87 Typical High $707.95 | Professional | None | $346.74 | $416.87 | $707.95 |
7 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 $208.93 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $208.93 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $83.18 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $316.23 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $63.10 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $41.69 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $295.12 | $354.81 | $354.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $186.21 Median $251.19 Typical High $309.03 | Professional | 51 · Multiple procedures | $186.21 | $251.19 | $309.03 |
Where South Carolina sits
The same service costs 6.1 times more in Vermont than in Maryland. 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
VT $6,769MD $1,107
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.