How much rates vary
Facilitymedian $794 · 10th to 90th $389 to $3,467Professionalmedian $214 · 10th to 90th $76 to $316
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 $97.72 Median $363.08 Typical High $16,595.87 | Facility | None | $97.72 | $363.08 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $173.78 Typical High $263.03 | Professional | None | $93.33 | $173.78 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $870.96 Typical High $2,951.21 | Facility | None | $501.19 | $870.96 | $2,951.21 |
BCBS South Carolina Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $239.88 | Professional | None | $74.13 | $112.20 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $562.34 Typical High $891.25 | Facility | None | $457.09 | $562.34 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $204.17 Typical High $323.59 | Professional | None | $87.10 | $204.17 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $97.72 Median $407.38 Typical High $676.08 | Facility | None | $97.72 | $407.38 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $331.13 | Professional | None | $199.53 | $257.04 | $331.13 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $398.11 | Professional | None | $218.78 | $275.42 | $398.11 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,025.60 | Facility | None | $302.00 | $1,122.02 | $6,025.60 |
United Setting Professional Modifier None Typical Low $70.79 Median $169.82 Typical High $309.03 | Professional | None | $70.79 | $169.82 | $309.03 |
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 $48.98 Median $61.66 Typical High $131.83 | Professional | 52 · Reduced service | $48.98 | $61.66 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $24.55 Typical High $52.48 | Professional | 53 · Discontinued | $19.95 | $24.55 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $91.20 Typical High $199.53 | Professional | 54 · Surgery only | $74.13 | $91.20 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $18.20 Typical High $39.81 | Professional | 55 · Aftercare only | $14.79 | $18.20 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $12.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $9.77 | $12.30 | $26.30 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $478.63 Typical High $602.56 | Professional | 50 · Both sides | $302.00 | $478.63 | $602.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $162.18 Typical High $199.53 | Professional | 51 · Multiple procedures | $100.00 | $162.18 | $199.53 |
Where South Carolina sits
The same service costs 6.5 times more in New York 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
NY $2,821MT $433
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.