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 $177.83 Median $3,801.89 Typical High $16,595.87 | Facility | None | $177.83 | $3,801.89 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $269.15 | Professional | None | $165.96 | $213.80 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $275.42 | Professional | None | $199.53 | $199.53 | $275.42 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $6,760.83 | Facility | None | $512.86 | $1,445.44 | $6,760.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $275.42 | Professional | None | $131.83 | $186.21 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $812.83 Typical High $1,348.96 | Facility | None | $457.09 | $812.83 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $281.84 | Professional | None | $131.83 | $177.83 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $436.52 Typical High $794.33 | Facility | None | $173.78 | $436.52 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $295.12 | Professional | None | $194.98 | $245.47 | $295.12 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $338.84 | Professional | None | $190.55 | $245.47 | $338.84 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $323.59 | Professional | None | $134.90 | $190.55 | $323.59 |
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 $89.13 Median $89.13 Typical High $120.23 | Professional | 52 · Reduced service | $89.13 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $47.86 | Professional | 53 · Discontinued | $35.48 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $181.97 | Professional | 54 · Surgery only | $131.83 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $23.99 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $169.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $123.03 Typical High $158.49 | Professional | 51 · Multiple procedures | $97.72 | $123.03 | $158.49 |
Where South Carolina sits
The same service costs 4.6 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· 32nd of 51
$224
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.