How much rates vary
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 $112.20 Median $269.15 Typical High $10,000.00 | Facility | None | $112.20 | $269.15 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $269.15 | Professional | None | $104.71 | $147.91 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $181.97 | Professional | None | $147.91 | $181.97 | $181.97 |
BCBS South Carolina Setting Facility Modifier None Typical Low $218.78 Median $380.19 Typical High $676.08 | Facility | None | $218.78 | $380.19 | $676.08 |
BCBS South Carolina Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $251.19 | Professional | None | $72.44 | $100.00 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $251.19 Typical High $407.38 | Facility | None | $75.86 | $251.19 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $263.03 | Professional | None | $100.00 | $173.78 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $120.23 Typical High $309.03 | Facility | None | $83.18 | $120.23 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $194.98 Typical High $281.84 | Professional | None | $79.43 | $194.98 | $281.84 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $239.88 Typical High $338.84 | Professional | None | $36.31 | $239.88 | $338.84 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,025.60 | Facility | None | $302.00 | $1,122.02 | $6,025.60 |
United Setting Professional Modifier None Typical Low $85.11 Median $151.36 Typical High $275.42 | Professional | None | $85.11 | $151.36 | $275.42 |
7 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 $56.23 Median $56.23 Typical High $134.90 | Professional | 52 · Reduced service | $56.23 | $56.23 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $53.70 | Professional | 53 · Discontinued | $22.39 | $22.39 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $199.53 | Professional | 54 · Surgery only | $85.11 | $85.11 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $40.74 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $26.92 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $79.43 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $79.43 | $79.43 | $190.55 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $97.72 Typical High $177.83 | Professional | 51 · Multiple procedures | $39.81 | $97.72 | $177.83 |
Where South Carolina sits
The same service costs 4.1 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· 42nd of 51
$182
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.