How much rates vary
Facilitymedian $2,570 · 10th to 90th $646 to $10,000Professionalmedian $302 · 10th to 90th $68 to $525
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 $398.11 Median $5,888.44 Typical High $21,877.62 | Facility | None | $398.11 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $398.11 | Professional | None | $309.03 | $398.11 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,949.84 Median $3,311.31 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,311.31 | $6,165.95 |
BCBS South Carolina Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $331.13 | Professional | None | $138.04 | $199.53 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $2,398.83 | Facility | None | $602.56 | $1,621.81 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $416.87 | Professional | None | $208.93 | $263.03 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $794.33 | Professional | None | $295.12 | $316.23 | $794.33 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $398.11 Typical High $537.03 | Facility | None | $190.55 | $398.11 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $389.05 | Professional | None | $275.42 | $323.59 | $389.05 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $363.08 Typical High $588.84 | Professional | None | $37.15 | $363.08 | $588.84 |
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 $218.78 Median $302.00 Typical High $446.68 | Professional | None | $218.78 | $302.00 | $446.68 |
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 $165.96 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $165.96 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $66.07 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $251.19 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $50.12 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.11 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $234.42 | $281.84 | $281.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $162.18 Typical High $239.88 | Professional | 51 · Multiple procedures | $138.04 | $162.18 | $239.88 |
Where South Carolina sits
The same service costs 5.5 times more in Colorado than in Michigan. 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 $4,792MI $877
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.