How much rates vary
Facilitymedian $1,905 · 10th to 90th $851 to $9,772Professionalmedian $575 · 10th to 90th $126 to $891
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 $537.03 Median $10,471.29 Typical High $21,877.62 | Facility | None | $537.03 | $10,471.29 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $758.58 | Professional | None | $537.03 | $588.84 | $758.58 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $2,570.40 Typical High $7,943.28 | Facility | None | $1,047.13 | $2,570.40 | $7,943.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $354.81 Median $645.65 Typical High $831.76 | Professional | None | $354.81 | $645.65 | $831.76 |
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 $380.19 Median $537.03 Typical High $954.99 | Professional | None | $380.19 | $537.03 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $812.83 Typical High $1,380.38 | Facility | None | $537.03 | $812.83 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $812.83 | Professional | None | $630.96 | $691.83 | $812.83 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $489.78 Typical High $933.25 | Professional | None | $97.72 | $489.78 | $933.25 |
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 $575.44 Typical High $954.99 | Professional | None | $407.38 | $575.44 | $954.99 |
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 $269.15 Median $281.84 Typical High $380.19 | Professional | 52 · Reduced service | $269.15 | $281.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $112.20 Typical High $151.36 | Professional | 53 · Discontinued | $107.15 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $575.44 | Professional | 54 · Surgery only | $398.11 | $416.87 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $114.82 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $56.23 Typical High $75.86 | Professional | 56 · Pre-op care only | $53.70 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $389.05 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $371.54 | $389.05 | $537.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,122.02 Typical High $1,288.25 | Professional | 50 · Both sides | $954.99 | $1,122.02 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $371.54 Typical High $426.58 | Professional | 51 · Multiple procedures | $316.23 | $371.54 | $426.58 |
Where South Carolina sits
The same service costs 3.3 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 $4,982MT $1,489
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.