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 $194.98 Median $5,248.07 Typical High $16,595.87 | Facility | None | $194.98 | $5,248.07 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $288.40 | Professional | None | $194.98 | $234.42 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | None | $165.96 | $173.78 | $173.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,318.26 Typical High $6,760.83 | Facility | None | $691.83 | $1,318.26 | $6,760.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $323.59 | Professional | None | $158.49 | $234.42 | $323.59 |
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 $151.36 Median $194.98 Typical High $302.00 | Professional | None | $151.36 | $194.98 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $588.84 Typical High $954.99 | Facility | None | $190.55 | $588.84 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $295.12 | Professional | None | $218.78 | $269.15 | $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 $147.91 Median $204.17 Typical High $354.81 | Professional | None | $147.91 | $204.17 | $354.81 |
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 $97.72 Median $97.72 Typical High $128.82 | Professional | 52 · Reduced service | $97.72 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $51.29 | Professional | 53 · Discontinued | $38.90 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $190.55 | Professional | 54 · Surgery only | $144.54 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $38.02 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $134.90 | $134.90 | $177.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $109.65 Median $134.90 Typical High $165.96 | Professional | 51 · Multiple procedures | $109.65 | $134.90 | $165.96 |
Where South Carolina sits
The same service costs 4.7 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· 33rd of 51
$240
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.