How much rates vary
Facilitymedian $269 · 10th to 90th $95 to $1,148Professionalmedian $115 · 10th to 90th $79 to $174
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 $114.82 Median $151.36 Typical High $9,120.11 | Facility | None | $114.82 | $151.36 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $162.18 | Professional | None | $100.00 | $125.89 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $208.93 | Professional | None | $102.33 | $120.23 | $208.93 |
BCBS South Carolina Setting Facility Modifier None Typical Low $199.53 Median $354.81 Typical High $645.65 | Facility | None | $199.53 | $354.81 | $645.65 |
BCBS South Carolina Setting Professional Modifier None Typical Low $48.98 Median $95.50 Typical High $128.82 | Professional | None | $48.98 | $95.50 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $154.88 | Facility | None | $75.86 | $100.00 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $169.82 | Professional | None | $95.50 | $109.65 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $120.23 Typical High $162.18 | Facility | None | $77.62 | $120.23 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $141.25 | Professional | None | $77.62 | $117.49 | $141.25 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $194.98 | Professional | None | $97.72 | $134.90 | $194.98 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $181.97 | Professional | None | $79.43 | $107.15 | $181.97 |
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 $57.54 Median $57.54 Typical High $67.61 | Professional | 52 · Reduced service | $57.54 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | 53 · Discontinued | $22.91 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | 54 · Surgery only | $85.11 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $20.42 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $79.43 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $79.43 | $79.43 | $95.50 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $173.78 Median $173.78 Typical High $177.83 | Professional | GC · Resident with teaching physician | $173.78 | $173.78 | $177.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.90 Median $58.88 Typical High $89.13 | Professional | 51 · Multiple procedures | $38.90 | $58.88 | $89.13 |
Where South Carolina sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 40th of 51
$117
AK $437KY $100
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.