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 $229.09 Median $5,248.07 Typical High $16,595.87 | Facility | None | $229.09 | $5,248.07 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $389.05 | Professional | None | $204.17 | $302.00 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
BCBS South Carolina Setting Facility Modifier None Typical Low $660.69 Median $1,174.90 Typical High $3,388.44 | Facility | None | $660.69 | $1,174.90 | $3,388.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $389.05 | Professional | None | $173.78 | $295.12 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $602.56 Typical High $1,047.13 | Facility | None | $436.52 | $602.56 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $398.11 | Professional | None | $173.78 | $251.19 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $489.78 Typical High $851.14 | Facility | None | $208.93 | $489.78 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $363.08 | Professional | None | $251.19 | $316.23 | $363.08 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $281.84 Typical High $398.11 | Professional | None | $36.31 | $281.84 | $398.11 |
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 $177.83 Median $269.15 Typical High $467.74 | Professional | None | $177.83 | $269.15 | $467.74 |
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 $114.82 Median $114.82 Typical High $165.96 | Professional | 52 · Reduced service | $114.82 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $67.61 | Professional | 53 · Discontinued | $45.71 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $251.19 | Professional | 54 · Surgery only | $173.78 | $173.78 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $50.12 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $33.88 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $234.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $158.49 Typical High $218.78 | Professional | 51 · Multiple procedures | $125.89 | $158.49 | $218.78 |
Where South Carolina sits
The same service costs 3.6 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· 38th 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.