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 $4,365.16 Typical High $16,595.87 | Facility | None | $194.98 | $4,365.16 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $275.42 | Professional | None | $190.55 | $223.87 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $239.88 | Professional | None | $162.18 | $239.88 | $239.88 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $3,801.89 | Facility | None | $1,258.93 | $2,187.76 | $3,801.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $309.03 | Professional | None | $151.36 | $208.93 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $363.08 Typical High $707.95 | Facility | None | $162.18 | $363.08 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $295.12 | Professional | None | $151.36 | $194.98 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $229.09 Typical High $295.12 | Facility | None | $151.36 | $229.09 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $257.04 | Professional | None | $204.17 | $229.09 | $257.04 |
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 $302.00 Median $1,122.02 Typical High $6,606.93 | Facility | None | $302.00 | $1,122.02 | $6,606.93 |
United Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $346.74 | Professional | None | $147.91 | $199.53 | $346.74 |
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 $123.03 | Professional | 52 · Reduced service | $97.72 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $48.98 | Professional | 53 · Discontinued | $38.90 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $186.21 | Professional | 54 · Surgery only | $144.54 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $37.15 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $134.90 | $134.90 | $173.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $112.20 Typical High $162.18 | Professional | 51 · Multiple procedures | $102.33 | $112.20 | $162.18 |
Where South Carolina sits
The same service costs 3.9 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
$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.