How much rates vary
Facilitymedian $1,778 · 10th to 90th $759 to $10,000Professionalmedian $1,047 · 10th to 90th $295 to $1,905
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 $309.03 Median $5,623.41 Typical High $21,877.62 | Facility | None | $309.03 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $1,047.13 Typical High $1,348.96 | Professional | None | $309.03 | $1,047.13 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $363.08 | Professional | None | $117.49 | $117.49 | $363.08 |
BCBS South Carolina Setting Facility Modifier None Typical Low $812.83 Median $1,778.28 Typical High $6,760.83 | Facility | None | $812.83 | $1,778.28 | $6,760.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $213.80 Median $562.34 Typical High $1,096.48 | Professional | None | $213.80 | $562.34 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $3,090.30 | Facility | None | $602.56 | $1,949.84 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $707.95 Typical High $1,778.28 | Professional | None | $346.74 | $707.95 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $912.01 Typical High $1,819.70 | Facility | None | $309.03 | $912.01 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,096.48 | $1,513.56 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $1,047.13 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,548.82 | $2,137.96 |
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 $257.04 Median $831.76 Typical High $1,949.84 | Professional | None | $257.04 | $831.76 | $1,949.84 |
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 $154.88 Median $169.82 Typical High $676.08 | Professional | 52 · Reduced service | $154.88 | $169.82 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $67.61 Typical High $275.42 | Professional | 53 · Discontinued | $61.66 | $67.61 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $257.04 Typical High $1,023.29 | Professional | 54 · Surgery only | $234.42 | $257.04 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $51.29 Typical High $204.17 | Professional | 55 · Aftercare only | $46.77 | $51.29 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.88 Typical High $134.90 | Professional | 56 · Pre-op care only | $30.90 | $33.88 | $134.90 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,238.72 Typical High $2,951.21 | Professional | 50 · Both sides | $2,137.96 | $2,238.72 | $2,951.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $741.31 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $724.44 | $741.31 | $1,000.00 |
Where South Carolina sits
The same service costs 3.2 times more in Oklahoma 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
OK $6,075KY $1,891
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.