How much rates vary
Facilitymedian $1,778 · 10th to 90th $794 to $9,772Professionalmedian $676 · 10th to 90th $115 to $1,047
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 $891.25 Median $10,000.00 Typical High $21,877.62 | Facility | None | $891.25 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $891.25 | Professional | None | $776.25 | $891.25 | $891.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $1,995.26 Typical High $7,943.28 | Facility | None | $851.14 | $1,995.26 | $7,943.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,148.15 | Professional | None | $588.84 | $891.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,949.84 | Facility | None | $602.56 | $1,230.27 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,288.25 | Professional | None | $602.56 | $676.08 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $851.14 Typical High $1,698.24 | Facility | None | $616.60 | $851.14 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,148.15 | Professional | None | $645.65 | $812.83 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $524.81 Typical High $1,000.00 | Professional | None | $102.33 | $524.81 | $1,000.00 |
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 $602.56 Median $758.58 Typical High $1,318.26 | Professional | None | $602.56 | $758.58 | $1,318.26 |
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 $436.52 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $436.52 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $660.69 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $131.83 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $87.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $616.60 | $630.96 | $630.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,288.25 Typical High $1,905.46 | Professional | 50 · Both sides | $977.24 | $1,288.25 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $426.58 Typical High $630.96 | Professional | 51 · Multiple procedures | $323.59 | $426.58 | $630.96 |
Where South Carolina sits
The same service costs 3.3 times more in Oklahoma than in Maryland. 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 $6,308MD $1,894
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.