How much rates vary
Facilitymedian $1,202 · 10th to 90th $501 to $8,318Professionalmedian $759 · 10th to 90th $182 to $1,175
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 $562.34 Median $4,897.79 Typical High $21,877.62 | Facility | None | $562.34 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $912.01 | Professional | None | $562.34 | $660.69 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,122.02 Typical High $7,079.46 | Facility | None | $512.86 | $1,122.02 | $7,079.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $870.96 | Professional | None | $426.58 | $645.65 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,023.29 Typical High $1,479.11 | Facility | None | $457.09 | $1,023.29 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $1,230.27 | Professional | None | $524.81 | $776.25 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $630.96 Typical High $1,288.25 | Facility | None | $436.52 | $630.96 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,023.29 | Professional | None | $741.31 | $870.96 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $831.76 Typical High $1,288.25 | Professional | None | $114.82 | $831.76 | $1,288.25 |
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 $407.38 Median $676.08 Typical High $1,096.48 | Professional | None | $407.38 | $676.08 | $1,096.48 |
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 $281.84 Median $316.23 Typical High $457.09 | Professional | 52 · Reduced service | $281.84 | $316.23 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $128.82 Typical High $181.97 | Professional | 53 · Discontinued | $112.20 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $478.63 Typical High $676.08 | Professional | 54 · Surgery only | $416.87 | $478.63 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $95.50 Typical High $134.90 | Professional | 55 · Aftercare only | $83.18 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $91.20 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $446.68 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $389.05 | $446.68 | $630.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,318.26 Typical High $2,041.74 | Professional | 50 · Both sides | $1,122.02 | $1,318.26 | $2,041.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $436.52 Typical High $676.08 | Professional | 51 · Multiple procedures | $371.54 | $436.52 | $676.08 |
Where South Carolina sits
The same service costs 3.0 times more in Colorado than in Maryland. 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 $5,106MD $1,697
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.