How much rates vary
Facilitymedian $1,738 · 10th to 90th $603 to $10,000Professionalmedian $372 · 10th to 90th $245 to $501
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 $338.84 Median $5,888.44 Typical High $21,877.62 | Facility | None | $338.84 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $338.84 | Professional | None | $281.84 | $338.84 | $338.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $3,019.95 Typical High $10,471.29 | Facility | None | $676.08 | $3,019.95 | $10,471.29 |
BCBS South Carolina Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $398.11 | Professional | None | $245.47 | $371.54 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,786.30 Typical High $6,760.83 | Facility | None | $602.56 | $4,786.30 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $501.19 | Professional | None | $346.74 | $416.87 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $338.84 Median $724.44 Typical High $776.25 | Facility | None | $338.84 | $724.44 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $457.09 | Professional | None | $331.13 | $457.09 | $457.09 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $501.19 | Professional | None | $251.19 | $323.59 | $501.19 |
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 $245.47 Median $323.59 Typical High $602.56 | Professional | None | $245.47 | $323.59 | $602.56 |
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 $141.25 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $141.25 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $56.23 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $213.80 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $42.66 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.18 | $33.88 | $33.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | 51 · Multiple procedures | $204.17 | $229.09 | $229.09 |
Where South Carolina sits
The same service costs 7.8 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 $7,005MT $893
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.