How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,995 to $19,498Professionalmedian $851 · 10th to 90th $479 to $1,380
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 $851.14 Median $10,964.78 Typical High $21,877.62 | Facility | None | $851.14 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,071.52 | Professional | None | $851.14 | $851.14 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,630.78 Median $7,079.46 Typical High $19,054.61 | Facility | None | $3,630.78 | $7,079.46 | $19,054.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $602.56 Median $1,380.38 Typical High $1,995.26 | Professional | None | $602.56 | $1,380.38 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,495.41 Typical High $7,585.78 | Facility | None | $602.56 | $5,495.41 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,584.89 | Professional | None | $977.24 | $1,000.00 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $851.14 Median $2,344.23 Typical High $3,090.30 | Facility | None | $851.14 | $2,344.23 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,513.56 | Professional | None | $794.33 | $1,122.02 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $741.31 Typical High $1,122.02 | Professional | None | $66.07 | $741.31 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,778.28 | Professional | None | $794.33 | $1,000.00 | $1,778.28 |
8 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 $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $125.89 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,778.28 Typical High $2,454.71 | Professional | 50 · Both sides | $1,479.11 | $1,778.28 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $588.84 Typical High $812.83 | Professional | 51 · Multiple procedures | $501.19 | $588.84 | $812.83 |
Where South Carolina sits
The same service costs 6.6 times more in Colorado than in Kentucky. 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 $14,612KY $2,222
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.