How much rates vary
Facilitymedian $1,778 · 10th to 90th $776 to $10,965Professionalmedian $724 · 10th to 90th $105 to $1,096
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 $758.58 Median $10,000.00 Typical High $21,877.62 | Facility | None | $758.58 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $758.58 | Professional | None | $676.08 | $758.58 | $758.58 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,235.94 Typical High $10,232.93 | Facility | None | $851.14 | $3,235.94 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,202.26 | Professional | None | $588.84 | $724.44 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $2,398.83 | Facility | None | $602.56 | $1,621.81 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $1,445.44 | Professional | None | $707.95 | $724.44 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $1,995.26 | Facility | None | $616.60 | $794.33 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,047.13 | Professional | None | $724.44 | $831.76 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $676.08 Typical High $1,071.52 | Professional | None | $83.18 | $676.08 | $1,071.52 |
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 $645.65 Median $794.33 Typical High $1,380.38 | Professional | None | $645.65 | $794.33 | $1,380.38 |
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 $338.84 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $338.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $134.90 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $512.86 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $67.61 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $537.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,258.93 Typical High $1,862.09 | Professional | 50 · Both sides | $1,122.02 | $1,258.93 | $1,862.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $416.87 Typical High $616.60 | Professional | 51 · Multiple procedures | $380.19 | $416.87 | $616.60 |
Where South Carolina sits
The same service costs 3.8 times more in Oklahoma than in West Virginia. 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 $7,251WV $1,923
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.