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 $257.04 Median $5,248.07 Typical High $16,595.87 | Facility | None | $257.04 | $5,248.07 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $363.08 | Professional | None | $239.88 | $309.03 | $363.08 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,288.25 Typical High $6,760.83 | Facility | None | $676.08 | $1,288.25 | $6,760.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $436.52 | Professional | None | $194.98 | $346.74 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $831.76 Typical High $1,348.96 | Facility | None | $602.56 | $831.76 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $436.52 | Professional | None | $199.53 | $275.42 | $436.52 |
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 $245.47 Median $588.84 Typical High $912.01 | Facility | None | $245.47 | $588.84 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $436.52 | Professional | None | $295.12 | $380.19 | $436.52 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $316.23 Typical High $457.09 | Professional | None | $36.31 | $316.23 | $457.09 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $512.86 | Professional | None | $199.53 | $288.40 | $512.86 |
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 $128.82 Median $128.82 Typical High $181.97 | Professional | 52 · Reduced service | $128.82 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $72.44 | Professional | 53 · Discontinued | $51.29 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $275.42 | Professional | 54 · Surgery only | $194.98 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $54.95 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $181.97 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $181.97 | $181.97 | $257.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $194.98 Typical High $239.88 | Professional | 51 · Multiple procedures | $147.91 | $194.98 | $239.88 |
Where South Carolina sits
The same service costs 4.0 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· 27th of 51
$363
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.