How much rates vary
Facilitymedian $1,862 · 10th to 90th $646 to $9,333Professionalmedian $195 · 10th to 90th $123 to $324
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 $199.53 Median $4,677.35 Typical High $16,595.87 | Facility | None | $199.53 | $4,677.35 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $269.15 | Professional | None | $177.83 | $199.53 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $2,041.74 Typical High $8,128.31 | Facility | None | $691.83 | $2,041.74 | $8,128.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $478.63 | Professional | None | $158.49 | $288.40 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,691.53 | Facility | None | $602.56 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $363.08 | Professional | None | $194.98 | $208.93 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $645.65 Typical High $1,479.11 | Facility | None | $199.53 | $645.65 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $380.19 | Professional | None | $208.93 | $251.19 | $380.19 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $281.84 | Professional | None | $112.20 | $181.97 | $281.84 |
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 $173.78 Median $213.80 Typical High $398.11 | Professional | None | $173.78 | $213.80 | $398.11 |
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 $89.13 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $89.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $35.48 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $26.30 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $17.78 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $141.25 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $123.03 | $141.25 | $141.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $125.89 Typical High $190.55 | Professional | 51 · Multiple procedures | $114.82 | $125.89 | $190.55 |
Where South Carolina sits
The same service costs 8.1 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 $4,634MT $570
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.