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 $169.82 Median $3,388.44 Typical High $16,595.87 | Facility | None | $169.82 | $3,388.44 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $251.19 | Professional | None | $165.96 | $199.53 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $288.40 | Professional | None | $89.13 | $97.72 | $288.40 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,290.87 Median $3,981.07 Typical High $7,585.78 | Facility | None | $2,290.87 | $3,981.07 | $7,585.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $234.42 | Professional | None | $100.00 | $151.36 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $331.13 Typical High $707.95 | Facility | None | $151.36 | $331.13 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $263.03 | Professional | None | $131.83 | $169.82 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $213.80 Typical High $275.42 | Facility | None | $138.04 | $213.80 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $234.42 | Professional | None | $169.82 | $204.17 | $234.42 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $288.40 | Professional | None | $162.18 | $208.93 | $288.40 |
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 $128.82 Median $177.83 Typical High $309.03 | Professional | None | $128.82 | $177.83 | $309.03 |
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 $85.11 Median $85.11 Typical High $109.65 | Professional | 52 · Reduced service | $85.11 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $44.67 | Professional | 53 · Discontinued | $33.88 | $33.88 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | 54 · Surgery only | $125.89 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $33.11 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $117.49 | $117.49 | $154.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $102.33 Typical High $144.54 | Professional | 51 · Multiple procedures | $83.18 | $102.33 | $144.54 |
Where South Carolina sits
The same service costs 4.0 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
$200
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.