How much rates vary
Facilitymedian $1,778 · 10th to 90th $759 to $9,333Professionalmedian $1,148 · 10th to 90th $257 to $2,188
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 $257.04 Median $1,445.44 Typical High $16,595.87 | Facility | None | $257.04 | $1,445.44 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $1,584.89 | Professional | None | $257.04 | $389.05 | $1,584.89 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $2,187.76 | Professional | None | $218.78 | $295.12 | $2,187.76 |
BCBS South Carolina Setting Facility Modifier None Typical Low $891.25 Median $1,778.28 Typical High $8,317.64 | Facility | None | $891.25 | $1,778.28 | $8,317.64 |
BCBS South Carolina Setting Professional Modifier None Typical Low $199.53 Median $478.63 Typical High $1,288.25 | Professional | None | $199.53 | $478.63 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,691.53 | Facility | None | $602.56 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $2,137.96 | Professional | None | $288.40 | $331.13 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $741.31 Typical High $1,949.84 | Facility | None | $257.04 | $741.31 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $1,737.80 | Professional | None | $380.19 | $562.34 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,778.28 | $2,454.71 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,754.23 Typical High $14,791.08 | Facility | None | $851.14 | $2,754.23 | $14,791.08 |
United Setting Professional Modifier None Typical Low $229.09 Median $446.68 Typical High $1,819.70 | Professional | None | $229.09 | $446.68 | $1,819.70 |
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 $125.89 Median $151.36 Typical High $724.44 | Professional | 52 · Reduced service | $125.89 | $151.36 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $60.26 Typical High $288.40 | Professional | 53 · Discontinued | $51.29 | $60.26 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $229.09 Typical High $1,071.52 | Professional | 54 · Surgery only | $190.55 | $229.09 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $45.71 Typical High $218.78 | Professional | 55 · Aftercare only | $38.02 | $45.71 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.20 Typical High $144.54 | Professional | 56 · Pre-op care only | $25.70 | $30.20 | $144.54 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $199.53 Median $199.53 Typical High $363.08 | Professional | GC · Resident with teaching physician | $199.53 | $199.53 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $190.55 Median $269.15 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $190.55 | $269.15 | $1,174.90 |
Where South Carolina sits
The same service costs 4.3 times more in Vermont than in Maine. 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
VT $8,043ME $1,891
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.