How much rates vary
Facilitymedian $1,175 · 10th to 90th $468 to $8,511Professionalmedian $214 · 10th to 90th $141 to $339
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 $169.82 Median $4,897.79 Typical High $21,877.62 | Facility | None | $169.82 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $251.19 | Professional | None | $147.91 | $190.55 | $251.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,412.54 Typical High $8,511.38 | Facility | None | $512.86 | $1,412.54 | $8,511.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $295.12 | Professional | None | $117.49 | $190.55 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,230.27 Typical High $1,737.80 | Facility | None | $457.09 | $1,230.27 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $363.08 | Professional | None | $141.25 | $218.78 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $436.52 Typical High $1,000.00 | Facility | None | $169.82 | $436.52 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $309.03 | Professional | None | $218.78 | $245.47 | $309.03 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $371.54 | Professional | None | $169.82 | $251.19 | $371.54 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $331.13 | Professional | None | $125.89 | $190.55 | $331.13 |
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 $79.43 Median $91.20 Typical High $123.03 | Professional | 52 · Reduced service | $79.43 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $36.31 Typical High $50.12 | Professional | 53 · Discontinued | $31.62 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $138.04 Typical High $186.21 | Professional | 54 · Surgery only | $117.49 | $138.04 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $27.54 Typical High $37.15 | Professional | 55 · Aftercare only | $23.44 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $128.82 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $109.65 | $128.82 | $173.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $123.03 Typical High $169.82 | Professional | 51 · Multiple procedures | $120.23 | $123.03 | $169.82 |
Where South Carolina sits
The same service costs 9.9 times more in Colorado than in Montana. 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 $4,605MT $466
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.