How much rates vary
Facilitymedian $871 · 10th to 90th $501 to $4,266Professionalmedian $427 · 10th to 90th $66 to $646
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 $223.87 Median $3,801.89 Typical High $16,595.87 | Facility | None | $223.87 | $3,801.89 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $416.87 Typical High $588.84 | Professional | None | $223.87 | $416.87 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $776.25 | Professional | None | $398.11 | $478.63 | $776.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $794.33 Typical High $2,818.38 | Facility | None | $512.86 | $794.33 | $2,818.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $446.68 | Professional | None | $165.96 | $275.42 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,047.13 Typical High $1,479.11 | Facility | None | $478.63 | $1,047.13 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $691.83 | Professional | None | $309.03 | $478.63 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $537.03 Typical High $1,174.90 | Facility | None | $245.47 | $537.03 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $831.76 | Professional | None | $489.78 | $588.84 | $831.76 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $436.52 Typical High $660.69 | Professional | None | $37.15 | $436.52 | $660.69 |
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 $199.53 Median $363.08 Typical High $707.95 | Professional | None | $199.53 | $363.08 | $707.95 |
9 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 $112.20 Median $154.88 Typical High $251.19 | Professional | 52 · Reduced service | $112.20 | $154.88 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $61.66 Typical High $102.33 | Professional | 53 · Discontinued | $44.67 | $61.66 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $234.42 Typical High $380.19 | Professional | 54 · Surgery only | $169.82 | $234.42 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $46.77 Typical High $75.86 | Professional | 55 · Aftercare only | $33.88 | $46.77 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $30.90 Typical High $50.12 | Professional | 56 · Pre-op care only | $22.39 | $30.90 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $218.78 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $158.49 | $218.78 | $354.81 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $660.69 Typical High $1,202.26 | Professional | 50 · Both sides | $275.42 | $660.69 | $1,202.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $891.25 Typical High $1,258.93 | Professional | 50 · Both sides | $870.96 | $891.25 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $295.12 Median $295.12 Typical High $416.87 | Professional | 51 · Multiple procedures | $295.12 | $295.12 | $416.87 |
Where South Carolina sits
The same service costs 4.6 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 $4,728MT $1,029
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.