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 $269.15 Median $3,388.44 Typical High $16,595.87 | Facility | None | $269.15 | $3,388.44 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $380.19 | Professional | None | $239.88 | $309.03 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $245.47 Typical High $398.11 | Professional | None | $239.88 | $245.47 | $398.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $6,760.83 | Facility | None | $691.83 | $1,737.80 | $6,760.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $407.38 | Professional | None | $218.78 | $257.04 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $831.76 Typical High $1,348.96 | Facility | None | $602.56 | $831.76 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $407.38 | Professional | None | $194.98 | $257.04 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $588.84 Typical High $870.96 | Facility | None | $213.80 | $588.84 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $416.87 | Professional | None | $251.19 | $354.81 | $416.87 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $316.23 Typical High $467.74 | Professional | None | $33.88 | $316.23 | $467.74 |
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 $199.53 Median $275.42 Typical High $457.09 | Professional | None | $199.53 | $275.42 | $457.09 |
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 $134.90 Median $134.90 Typical High $173.78 | Professional | 52 · Reduced service | $134.90 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $69.18 | Professional | 53 · Discontinued | $53.70 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $257.04 | Professional | 54 · Surgery only | $199.53 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $51.29 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $239.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $177.83 Typical High $223.87 | Professional | 51 · Multiple procedures | $125.89 | $177.83 | $223.87 |
Where South Carolina sits
The same service costs 4.8 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· 36th of 51
$316
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.