How much rates vary
Facilitymedian $10,471 · 10th to 90th $1,862 to $37,154Professionalmedian $933 · 10th to 90th $617 to $1,288
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 $660.69 Median $18,620.87 Typical High $53,703.18 | Facility | None | $660.69 | $18,620.87 | $53,703.18 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,479.11 | Professional | None | $645.65 | $660.69 | $1,479.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $11,748.98 Typical High $36,307.81 | Facility | None | $1,905.46 | $11,748.98 | $36,307.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $616.60 Median $1,230.27 Typical High $1,698.24 | Professional | None | $616.60 | $1,230.27 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $8,912.51 Median $12,022.64 Typical High $48,977.88 | Facility | None | $8,912.51 | $12,022.64 | $48,977.88 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,584.89 | Professional | None | $741.31 | $851.14 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $724.44 Typical High $1,778.28 | Facility | None | $660.69 | $724.44 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,000.00 | Professional | None | $741.31 | $741.31 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,258.93 | Professional | None | $630.96 | $912.01 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $26,915.35 | Facility | None | $1,819.70 | $6,606.93 | $26,915.35 |
United Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,230.27 | Professional | None | $645.65 | $812.83 | $1,230.27 |
5 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 $323.59 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $323.59 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $128.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $478.63 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $66.07 |
Where South Carolina sits
The same service costs 9.6 times more in Oklahoma 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
OK $19,472MT $2,030
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.