How much rates vary
Facilitymedian $1,905 · 10th to 90th $891 to $10,715Professionalmedian $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 $9,549.93 Typical High $20,417.38 | Facility | None | $416.87 | $9,549.93 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $478.63 | Professional | None | $316.23 | $416.87 | $478.63 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $9,549.93 | Facility | None | $1,023.29 | $3,311.31 | $9,549.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $691.83 | Professional | None | $288.40 | $512.86 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,148.15 Typical High $1,819.70 | Facility | None | $630.96 | $1,148.15 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $707.95 | Professional | None | $363.08 | $363.08 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $354.81 Median $891.25 Typical High $1,288.25 | Facility | None | $354.81 | $891.25 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $616.60 | Professional | None | $354.81 | $426.58 | $616.60 |
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 $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 $316.23 Median $371.54 Typical High $660.69 | Professional | None | $316.23 | $371.54 | $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 $63.10 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $63.10 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $234.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $46.77 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $31.62 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $218.78 | $288.40 | $288.40 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $645.65 Typical High $933.25 | Professional | 50 · Both sides | $537.03 | $645.65 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $213.80 Typical High $309.03 | Professional | 51 · Multiple procedures | $177.83 | $213.80 | $309.03 |
Where South Carolina sits
The same service costs 5.1 times more in Oklahoma 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
OK $5,094MT $991
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.