How much rates vary
Facilitymedian $2,138 · 10th to 90th $776 to $11,482Professionalmedian $389 · 10th to 90th $69 to $575
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 $416.87 Median $8,912.51 Typical High $20,417.38 | Facility | None | $416.87 | $8,912.51 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $436.52 | Professional | None | $323.59 | $416.87 | $436.52 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,019.95 Typical High $9,549.93 | Facility | None | $851.14 | $3,019.95 | $9,549.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $295.12 Median $537.03 Typical High $776.25 | Professional | None | $295.12 | $537.03 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,630.27 | Facility | None | $602.56 | $1,862.09 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $707.95 | Professional | None | $363.08 | $371.54 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $741.31 Typical High $1,698.24 | Facility | None | $363.08 | $741.31 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $537.03 | Professional | None | $354.81 | $436.52 | $537.03 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $354.81 Typical High $549.54 | Professional | None | $56.23 | $354.81 | $549.54 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $660.69 | Professional | None | $316.23 | $389.05 | $660.69 |
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 $158.49 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $158.49 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $64.57 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $239.88 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $47.86 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $32.36 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $223.87 | $295.12 | $295.12 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $645.65 Typical High $912.01 | Professional | 50 · Both sides | $537.03 | $645.65 | $912.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $213.80 Typical High $295.12 | Professional | 51 · Multiple procedures | $177.83 | $213.80 | $295.12 |
Where South Carolina sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.