How much rates vary
Facilitymedian $1,549 · 10th to 90th $490 to $9,550Professionalmedian $513 · 10th to 90th $155 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 $213.80 Median $933.25 Typical High $16,595.87 | Facility | None | $213.80 | $933.25 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $467.74 Typical High $645.65 | Professional | None | $190.55 | $467.74 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | None | $151.36 | $151.36 | $158.49 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $8,511.38 | Facility | None | $512.86 | $1,778.28 | $8,511.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $575.44 | Professional | None | $165.96 | $309.03 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,479.11 Typical High $2,187.76 | Facility | None | $457.09 | $1,479.11 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $436.52 Typical High $676.08 | Professional | None | $181.97 | $436.52 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $1,348.96 | Professional | None | $616.60 | $660.69 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $501.19 Typical High $1,479.11 | Facility | None | $213.80 | $501.19 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $616.60 | Professional | None | $446.68 | $588.84 | $616.60 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $562.34 Typical High $933.25 | Professional | None | $74.13 | $562.34 | $933.25 |
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 $162.18 Median $398.11 Typical High $707.95 | Professional | None | $162.18 | $398.11 | $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 $104.71 Median $190.55 Typical High $323.59 | Professional | 52 · Reduced service | $104.71 | $190.55 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $75.86 Typical High $128.82 | Professional | 53 · Discontinued | $41.69 | $75.86 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $288.40 Typical High $478.63 | Professional | 54 · Surgery only | $154.88 | $288.40 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $57.54 Typical High $95.50 | Professional | 55 · Aftercare only | $30.90 | $57.54 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $38.02 Typical High $64.57 | Professional | 56 · Pre-op care only | $20.89 | $38.02 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $269.15 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $144.54 | $269.15 | $446.68 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $295.12 Typical High $389.05 | Professional | 51 · Multiple procedures | $223.87 | $295.12 | $389.05 |
Where South Carolina sits
The same service costs 4.4 times more in Colorado 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
CO $4,844ND $1,099
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.