How much rates vary
Facilitymedian $537 · 10th to 90th $155 to $1,122Professionalmedian $234 · 10th to 90th $148 to $398
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 $602.56 Typical High $16,595.87 | Facility | None | $169.82 | $602.56 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $281.84 | Professional | None | $154.88 | $213.80 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
BCBS South Carolina Setting Facility Modifier None Typical Low $338.84 Median $602.56 Typical High $870.96 | Facility | None | $338.84 | $602.56 | $870.96 |
BCBS South Carolina Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $275.42 | Professional | None | $125.89 | $208.93 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $371.54 Typical High $707.95 | Facility | None | $154.88 | $371.54 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $389.05 | Professional | None | $154.88 | $234.42 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $281.84 Typical High $630.96 | Facility | None | $109.65 | $281.84 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $295.12 | Professional | None | $204.17 | $269.15 | $295.12 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $446.68 | Professional | None | $223.87 | $323.59 | $446.68 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $380.19 | Professional | None | $131.83 | $213.80 | $380.19 |
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 $81.28 Median $95.50 Typical High $141.25 | Professional | 52 · Reduced service | $81.28 | $95.50 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $38.90 Typical High $56.23 | Professional | 53 · Discontinued | $32.36 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $144.54 Typical High $208.93 | Professional | 54 · Surgery only | $123.03 | $144.54 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.84 Typical High $41.69 | Professional | 55 · Aftercare only | $24.55 | $28.84 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.50 Typical High $28.18 | Professional | 56 · Pre-op care only | $16.22 | $19.50 | $28.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $134.90 Typical High $194.98 | Professional | 51 · Multiple procedures | $102.33 | $134.90 | $194.98 |
Where South Carolina sits
The same service costs 8.8 times more in New York than in Alabama. 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
NY $2,761AL $314
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.