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 $162.18 Median $4,365.16 Typical High $16,595.87 | Facility | None | $162.18 | $4,365.16 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $288.40 | Professional | None | $144.54 | $208.93 | $288.40 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,202.26 Typical High $2,089.30 | Facility | None | $676.08 | $1,202.26 | $2,089.30 |
BCBS South Carolina Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $288.40 | Professional | None | $123.03 | $234.42 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $380.19 Typical High $707.95 | Facility | None | $173.78 | $380.19 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $295.12 | Professional | None | $123.03 | $186.21 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $158.49 Median $245.47 Typical High $331.13 | Facility | None | $158.49 | $245.47 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $263.03 | Professional | None | $190.55 | $251.19 | $263.03 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $338.84 | Professional | None | $190.55 | $245.47 | $338.84 |
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 $125.89 Median $190.55 Typical High $331.13 | Professional | None | $125.89 | $190.55 | $331.13 |
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 $81.28 Median $81.28 Typical High $123.03 | Professional | 52 · Reduced service | $81.28 | $81.28 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $50.12 | Professional | 53 · Discontinued | $32.36 | $32.36 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $186.21 | Professional | 54 · Surgery only | $120.23 | $120.23 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $37.15 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $112.20 | $112.20 | $173.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $125.89 Typical High $162.18 | Professional | 51 · Multiple procedures | $95.50 | $125.89 | $162.18 |
Where South Carolina sits
The same service costs 3.4 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· 26th of 51
$234
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.