How much rates vary
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 $588.84 Median $10,471.29 Typical High $21,877.62 | Facility | None | $588.84 | $10,471.29 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $602.56 | Professional | None | $446.68 | $588.84 | $602.56 |
BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,388.44 Typical High $9,549.93 | Facility | None | $1,047.13 | $3,388.44 | $9,549.93 |
BCBS Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $851.14 | Professional | None | $398.11 | $588.84 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,862.09 Typical High $2,884.03 | Facility | None | $630.96 | $1,862.09 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $977.24 | Professional | None | $512.86 | $512.86 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $912.01 Typical High $1,737.80 | Facility | None | $501.19 | $912.01 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $660.69 | Professional | None | $467.74 | $602.56 | $660.69 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $467.74 Typical High $741.31 | Professional | None | $56.23 | $467.74 | $741.31 |
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 $436.52 Median $524.81 Typical High $933.25 | Professional | None | $436.52 | $524.81 | $933.25 |
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 $218.78 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $218.78 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $89.13 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $331.13 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $66.07 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $44.67 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $309.03 | $407.38 | $407.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $912.01 Typical High $1,258.93 | Professional | 50 · Both sides | $707.95 | $912.01 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $302.00 Typical High $398.11 | Professional | 51 · Multiple procedures | $234.42 | $302.00 | $398.11 |
Where South Carolina sits
The same service costs 8.9 times more in Oklahoma than in Utah. 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.
South Carolina· 42nd of 51
$589
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.