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 $208.93 Median $3,801.89 Typical High $16,595.87 | Facility | None | $208.93 | $3,801.89 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $346.74 | Professional | None | $186.21 | $269.15 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $263.03 Typical High $467.74 | Professional | None | $120.23 | $263.03 | $467.74 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $3,715.35 | Facility | None | $1,258.93 | $2,187.76 | $3,715.35 |
BCBS South Carolina Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $346.74 | Professional | None | $158.49 | $245.47 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $389.05 Typical High $707.95 | Facility | None | $194.98 | $389.05 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $363.08 | Professional | None | $158.49 | $229.09 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $302.00 Typical High $389.05 | Facility | None | $190.55 | $302.00 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $331.13 | Professional | None | $229.09 | $288.40 | $331.13 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $239.88 Typical High $346.74 | Professional | None | $36.31 | $239.88 | $346.74 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,025.60 | Facility | None | $302.00 | $1,122.02 | $6,025.60 |
United Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $426.58 | Professional | None | $162.18 | $239.88 | $426.58 |
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 $104.71 Median $104.71 Typical High $151.36 | Professional | 52 · Reduced service | $104.71 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $60.26 | Professional | 53 · Discontinued | $41.69 | $41.69 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $223.87 | Professional | 54 · Surgery only | $158.49 | $158.49 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $45.71 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $208.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $144.54 Typical High $199.53 | Professional | 51 · Multiple procedures | $112.20 | $144.54 | $199.53 |
Where South Carolina sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 40th of 51
$257
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.