How much rates vary
Facilitymedian $1,230 · 10th to 90th $501 to $8,913Professionalmedian $275 · 10th to 90th $166 to $407
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 $316.23 Median $5,623.41 Typical High $21,877.62 | Facility | None | $316.23 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $316.23 | Professional | None | $263.03 | $316.23 | $316.23 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,148.15 Typical High $7,585.78 | Facility | None | $512.86 | $1,148.15 | $7,585.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $245.47 Median $263.03 Typical High $338.84 | Professional | None | $245.47 | $263.03 | $338.84 |
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 $323.59 Median $331.13 Typical High $489.78 | Professional | None | $323.59 | $331.13 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $501.19 Typical High $1,288.25 | Facility | None | $309.03 | $501.19 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $416.87 | Professional | None | $309.03 | $346.74 | $416.87 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $229.09 Typical High $338.84 | Professional | None | $42.66 | $229.09 | $338.84 |
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 $223.87 Median $288.40 Typical High $478.63 | Professional | None | $223.87 | $288.40 | $478.63 |
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 $131.83 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $131.83 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $52.48 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $199.53 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $39.81 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.30 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $186.21 | $223.87 | $223.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $194.98 Typical High $239.88 | Professional | 51 · Multiple procedures | $162.18 | $194.98 | $239.88 |
Where South Carolina sits
The same service costs 5.6 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 $4,847MT $873
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.