How much rates vary
Facilitymedian $851 · 10th to 90th $479 to $4,571Professionalmedian $224 · 10th to 90th $148 to $316
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 $199.53 Median $5,623.41 Typical High $21,877.62 | Facility | None | $199.53 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $213.80 | Professional | None | $165.96 | $199.53 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $870.96 Typical High $3,801.89 | Facility | None | $501.19 | $870.96 | $3,801.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $147.91 Median $281.84 Typical High $288.40 | Professional | None | $147.91 | $281.84 | $288.40 |
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 $199.53 Median $251.19 Typical High $331.13 | Professional | None | $199.53 | $251.19 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $380.19 | Professional | None | $309.03 | $331.13 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $436.52 Typical High $851.14 | Facility | None | $208.93 | $436.52 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $316.23 | Professional | None | $194.98 | $302.00 | $316.23 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $257.04 | Professional | None | $128.82 | $162.18 | $257.04 |
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 $144.54 Median $213.80 Typical High $389.05 | Professional | None | $144.54 | $213.80 | $389.05 |
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 $83.18 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $83.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $33.11 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $25.12 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.60 | $19.95 | $19.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $151.36 Typical High $158.49 | Professional | 51 · Multiple procedures | $120.23 | $151.36 | $158.49 |
Where South Carolina sits
The same service costs 7.7 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 $4,047MT $526
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.