How much rates vary
Facilitymedian $1,778 · 10th to 90th $676 to $6,457Professionalmedian $776 · 10th to 90th $195 to $1,175
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 $229.09 Median $5,623.41 Typical High $21,877.62 | Facility | None | $229.09 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $549.54 Typical High $1,047.13 | Professional | None | $218.78 | $549.54 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $812.83 Median $1,778.28 Typical High $6,025.60 | Facility | None | $812.83 | $1,778.28 | $6,025.60 |
BCBS South Carolina Setting Professional Modifier None Typical Low $162.18 Median $537.03 Typical High $1,047.13 | Professional | None | $162.18 | $537.03 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $933.25 Typical High $3,090.30 | Facility | None | $602.56 | $933.25 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $575.44 Typical High $1,148.15 | Professional | None | $245.47 | $575.44 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $724.44 Typical High $1,412.54 | Facility | None | $229.09 | $724.44 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,148.15 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,513.56 | Professional | None | $758.58 | $1,000.00 | $1,513.56 |
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 $186.21 Median $630.96 Typical High $1,348.96 | Professional | None | $186.21 | $630.96 | $1,348.96 |
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 $112.20 Median $275.42 Typical High $512.86 | Professional | 52 · Reduced service | $112.20 | $275.42 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $112.20 Typical High $208.93 | Professional | 53 · Discontinued | $45.71 | $112.20 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $416.87 Typical High $776.25 | Professional | 54 · Surgery only | $169.82 | $416.87 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $83.18 Typical High $154.88 | Professional | 55 · Aftercare only | $33.88 | $83.18 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $54.95 Typical High $104.71 | Professional | 56 · Pre-op care only | $22.91 | $54.95 | $104.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | 51 · Multiple procedures | $575.44 | $575.44 | $630.96 |
Where South Carolina sits
The same service costs 5.2 times more in Colorado 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
CO $5,090MD $977
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.