How much rates vary
Facilitymedian $1,023 · 10th to 90th $479 to $7,079Professionalmedian $447 · 10th to 90th $55 to $741
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 $363.08 Median $707.95 Typical High $16,595.87 | Facility | None | $363.08 | $707.95 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $512.86 | Professional | None | $363.08 | $457.09 | $512.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $6,760.83 | Facility | None | $512.86 | $1,445.44 | $6,760.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $501.19 | Professional | None | $288.40 | $338.84 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,348.96 Typical High $1,905.46 | Facility | None | $457.09 | $1,348.96 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $870.96 | Professional | None | $338.84 | $457.09 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $512.86 Typical High $1,096.48 | Facility | None | $269.15 | $512.86 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $645.65 | Professional | None | $407.38 | $467.74 | $645.65 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $489.78 Typical High $794.33 | Professional | None | $40.74 | $489.78 | $794.33 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $776.25 | Professional | None | $309.03 | $467.74 | $776.25 |
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 $177.83 Median $199.53 Typical High $257.04 | Professional | 52 · Reduced service | $177.83 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $79.43 Typical High $102.33 | Professional | 53 · Discontinued | $72.44 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $295.12 Typical High $389.05 | Professional | 54 · Surgery only | $269.15 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $60.26 Typical High $77.62 | Professional | 55 · Aftercare only | $53.70 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $39.81 Typical High $51.29 | Professional | 56 · Pre-op care only | $36.31 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $275.42 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $251.19 | $275.42 | $363.08 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $707.95 Typical High $1,230.27 | Professional | 50 · Both sides | $602.56 | $707.95 | $1,230.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $234.42 Typical High $416.87 | Professional | 51 · Multiple procedures | $204.17 | $234.42 | $416.87 |
Where South Carolina sits
The same service costs 5.0 times more in Colorado than in Delaware. 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 $5,773DE $1,161
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.