How much rates vary
Facilitymedian $1,349 · 10th to 90th $661 to $9,120Professionalmedian $339 · 10th to 90th $110 to $513
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 $457.09 Median $5,888.44 Typical High $21,877.62 | Facility | None | $457.09 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $457.09 | Professional | None | $354.81 | $457.09 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,288.25 Typical High $7,762.47 | Facility | None | $691.83 | $1,288.25 | $7,762.47 |
BCBS South Carolina Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $389.05 | Professional | None | $295.12 | $309.03 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $1,862.09 | Facility | None | $602.56 | $1,202.26 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $645.65 | Professional | None | $288.40 | $338.84 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $426.58 Median $676.08 Typical High $1,479.11 | Facility | None | $426.58 | $676.08 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $426.58 | Professional | None | $338.84 | $407.38 | $426.58 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $309.03 Typical High $512.86 | Professional | None | $81.28 | $309.03 | $512.86 |
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 $302.00 Median $380.19 Typical High $660.69 | Professional | None | $302.00 | $380.19 | $660.69 |
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 $223.87 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $223.87 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $89.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $331.13 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $309.03 | $316.23 | $316.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $213.80 Typical High $257.04 | Professional | 51 · Multiple procedures | $169.82 | $213.80 | $257.04 |
Where South Carolina sits
The same service costs 4.5 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 $4,914MT $1,099
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.