How much rates vary
Facilitymedian $1,905 · 10th to 90th $912 to $10,965Professionalmedian $490 · 10th to 90th $110 to $933
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 $10,964.78 Typical High $21,877.62 | Facility | None | $562.34 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $707.95 | Professional | None | $524.81 | $562.34 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $3,388.44 Typical High $10,000.00 | Facility | None | $1,047.13 | $3,388.44 | $10,000.00 |
BCBS South Carolina Setting Professional Modifier None Typical Low $371.54 Median $851.14 Typical High $1,096.48 | Professional | None | $371.54 | $851.14 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,230.27 Typical High $1,949.84 | Facility | None | $630.96 | $1,230.27 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $912.01 | Professional | None | $524.81 | $616.60 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $1,380.38 | Facility | None | $562.34 | $912.01 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $870.96 | Professional | None | $512.86 | $602.56 | $870.96 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $371.54 Typical High $588.84 | Professional | None | $81.28 | $371.54 | $588.84 |
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 $549.54 Median $691.83 Typical High $1,122.02 | Professional | None | $549.54 | $691.83 | $1,122.02 |
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 $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $398.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,047.13 Typical High $1,318.26 | Professional | 50 · Both sides | $831.76 | $1,047.13 | $1,318.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $354.81 Typical High $457.09 | Professional | 51 · Multiple procedures | $275.42 | $354.81 | $457.09 |
Where South Carolina sits
The same service costs 4.6 times more in Oklahoma 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
OK $6,462MT $1,416
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.