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 $125.89 Median $251.19 Typical High $10,000.00 | Facility | None | $125.89 | $251.19 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $208.93 | Professional | None | $123.03 | $162.18 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $123.03 Typical High $295.12 | Professional | None | $69.18 | $123.03 | $295.12 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,202.26 Typical High $1,995.26 | Facility | None | $676.08 | $1,202.26 | $1,995.26 |
BCBS South Carolina Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $173.78 | Professional | None | $75.86 | $112.20 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $295.12 Typical High $707.95 | Facility | None | $131.83 | $295.12 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $213.80 | Professional | None | $93.33 | $134.90 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $186.21 Typical High $251.19 | Facility | None | $123.03 | $186.21 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $223.87 | Professional | None | $131.83 | $186.21 | $223.87 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $239.88 | Professional | None | $131.83 | $169.82 | $239.88 |
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 $95.50 Median $141.25 Typical High $245.47 | Professional | None | $95.50 | $141.25 | $245.47 |
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 $63.10 Median $63.10 Typical High $93.33 | Professional | 52 · Reduced service | $63.10 | $63.10 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $37.15 | Professional | 53 · Discontinued | $25.12 | $25.12 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $138.04 | Professional | 54 · Surgery only | $93.33 | $93.33 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $27.54 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $87.10 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $87.10 | $87.10 | $128.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $66.07 Median $93.33 Typical High $123.03 | Professional | 51 · Multiple procedures | $66.07 | $93.33 | $123.03 |
Where South Carolina sits
The same service costs 3.8 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· 41st of 51
$155
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.