How much rates vary
Facilitymedian $1,349 · 10th to 90th $661 to $9,120Professionalmedian $158 · 10th to 90th $89 to $257
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 $165.96 Median $5,888.44 Typical High $21,877.62 | Facility | None | $165.96 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $190.55 | Professional | None | $158.49 | $165.96 | $190.55 |
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 $112.20 Median $158.49 Typical High $257.04 | Professional | None | $112.20 | $158.49 | $257.04 |
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 $165.96 Median $190.55 Typical High $275.42 | Professional | None | $165.96 | $190.55 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $645.65 Typical High $1,380.38 | Facility | None | $169.82 | $645.65 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $269.15 | Professional | None | $151.36 | $177.83 | $269.15 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $251.19 | Professional | None | $69.18 | $128.82 | $251.19 |
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 $123.03 Median $173.78 Typical High $309.03 | Professional | None | $123.03 | $173.78 | $309.03 |
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 $83.18 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 54 · Surgery only | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $117.49 | $117.49 | $117.49 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $288.40 Typical High $398.11 | Professional | 50 · Both sides | $269.15 | $288.40 | $398.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $89.13 Median $95.50 Typical High $134.90 | Professional | 51 · Multiple procedures | $89.13 | $95.50 | $134.90 |
Where South Carolina sits
The same service costs 11.0 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 $4,556MT $413
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.