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 $131.83 Median $4,365.16 Typical High $16,595.87 | Facility | None | $131.83 | $4,365.16 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $239.88 | Professional | None | $120.23 | $190.55 | $239.88 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $3,890.45 | Facility | None | $1,288.25 | $2,187.76 | $3,890.45 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $218.78 | Professional | None | $104.71 | $173.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $346.74 Typical High $707.95 | Facility | None | $154.88 | $346.74 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $251.19 | Professional | None | $95.50 | $154.88 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $218.78 Typical High $288.40 | Facility | None | $131.83 | $218.78 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $223.87 | Professional | None | $162.18 | $194.98 | $223.87 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $281.84 | Professional | None | $134.90 | $194.98 | $281.84 |
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 $100.00 Median $162.18 Typical High $281.84 | Professional | None | $100.00 | $162.18 | $281.84 |
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 $66.07 Median $66.07 Typical High $107.15 | Professional | 52 · Reduced service | $66.07 | $66.07 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $42.66 | Professional | 53 · Discontinued | $26.30 | $26.30 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $162.18 | Professional | 54 · Surgery only | $100.00 | $100.00 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $32.36 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $93.33 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $93.33 | $93.33 | $151.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $81.28 Median $97.72 Typical High $141.25 | Professional | 51 · Multiple procedures | $81.28 | $97.72 | $141.25 |
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· 35th of 51
$186
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.