How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,259 to $15,488Professionalmedian $631 · 10th to 90th $251 to $1,072
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 $645.65 Median $7,762.47 Typical High $21,877.62 | Facility | None | $645.65 | $7,762.47 | $21,877.62 |
Aetna Setting Professional Modifier None (both parts) Typical Low $645.65 Median $645.65 Typical High $1,023.29 | Professional | None (both parts) | $645.65 | $645.65 | $1,023.29 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 26 · Professional part | $218.78 | $229.09 | $229.09 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $416.87 Median $416.87 Typical High $446.68 | Professional | TC · Technical part | $416.87 | $416.87 | $446.68 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,454.71 Median $5,623.41 Typical High $8,128.31 | Facility | None | $2,454.71 | $5,623.41 | $8,128.31 |
BCBS South Carolina Setting Facility Modifier TC · Technical part Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | TC · Technical part | $3,311.31 | $3,311.31 | $3,311.31 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $457.09 Median $602.56 Typical High $812.83 | Professional | None (both parts) | $457.09 | $602.56 | $812.83 |
BCBS South Carolina Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $436.52 Typical High $478.63 | Professional | 26 · Professional part | $208.93 | $436.52 | $478.63 |
BCBS South Carolina Setting Professional Modifier TC · Technical part Typical Low $186.21 Median $239.88 Typical High $416.87 | Professional | TC · Technical part | $186.21 | $239.88 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $2,884.03 | Facility | None | $100.00 | $100.00 | $2,884.03 |
Cigna Setting Professional Modifier None (both parts) Typical Low $398.11 Median $776.25 Typical High $1,513.56 | Professional | None (both parts) | $398.11 | $776.25 | $1,513.56 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $275.42 Typical High $537.03 | Professional | 26 · Professional part | $251.19 | $275.42 | $537.03 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $104.71 Median $524.81 Typical High $977.24 | Professional | TC · Technical part | $104.71 | $524.81 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $645.65 Typical High $1,698.24 | Facility | None | $295.12 | $645.65 | $1,698.24 |
Medcost Setting Professional Modifier None (both parts) Typical Low $512.86 Median $812.83 Typical High $977.24 | Professional | None (both parts) | $512.86 | $812.83 | $977.24 |
Molina Setting Professional Modifier None (both parts) Typical Low $234.42 Median $575.44 Typical High $1,047.13 | Professional | None (both parts) | $234.42 | $575.44 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None (both parts) Typical Low $398.11 Median $758.58 Typical High $1,202.26 | Professional | None (both parts) | $398.11 | $758.58 | $1,202.26 |
United Setting Professional Modifier 26 · Professional part Typical Low $218.78 Median $275.42 Typical High $426.58 | Professional | 26 · Professional part | $218.78 | $275.42 | $426.58 |
United Setting Professional Modifier TC · Technical part Typical Low $93.33 Median $501.19 Typical High $812.83 | Professional | TC · Technical part | $93.33 | $501.19 | $812.83 |
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 $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
Where South Carolina sits
The same service costs 4.4 times more in Wisconsin than in Texas. 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.
South Carolina· 48th of 51
$646
WI $2,630TX $603
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.