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 $245.47 Median $4,365.16 Typical High $16,595.87 | Facility | None | $245.47 | $4,365.16 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $309.03 | Professional | None | $223.87 | $275.42 | $309.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $912.01 Typical High $3,467.37 | Facility | None | $512.86 | $912.01 | $3,467.37 |
BCBS South Carolina Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $380.19 | Professional | None | $173.78 | $275.42 | $380.19 |
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 $194.98 Median $251.19 Typical High $371.54 | Professional | None | $194.98 | $251.19 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $416.87 Typical High $776.25 | Facility | None | $239.88 | $416.87 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $331.13 | Professional | None | $234.42 | $288.40 | $331.13 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $229.09 Typical High $346.74 | Professional | None | $33.88 | $229.09 | $346.74 |
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 $190.55 Median $251.19 Typical High $436.52 | Professional | None | $190.55 | $251.19 | $436.52 |
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 $123.03 Median $123.03 Typical High $154.88 | Professional | 52 · Reduced service | $123.03 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $48.98 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | 54 · Surgery only | $181.97 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $30.90 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $169.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $169.82 | $169.82 | $213.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $144.54 Typical High $199.53 | Professional | 51 · Multiple procedures | $117.49 | $144.54 | $199.53 |
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· 32nd of 51
$295
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.