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 $302.00 Median $5,248.07 Typical High $16,595.87 | Facility | None | $302.00 | $5,248.07 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $489.78 | Professional | None | $302.00 | $380.19 | $489.78 |
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 $229.09 Median $426.58 Typical High $575.44 | Professional | None | $229.09 | $426.58 | $575.44 |
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 $245.47 Median $331.13 Typical High $501.19 | Professional | None | $245.47 | $331.13 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $302.00 Median $588.84 Typical High $954.99 | Facility | None | $302.00 | $588.84 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $501.19 | Professional | None | $363.08 | $446.68 | $501.19 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $371.54 Typical High $537.03 | Professional | None | $36.31 | $371.54 | $537.03 |
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 $239.88 Median $338.84 Typical High $616.60 | Professional | None | $239.88 | $338.84 | $616.60 |
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 $151.36 Median $151.36 Typical High $208.93 | Professional | 52 · Reduced service | $151.36 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $83.18 | Professional | 53 · Discontinued | $61.66 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | 54 · Surgery only | $229.09 | $229.09 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $41.69 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $295.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $229.09 Typical High $275.42 | Professional | 51 · Multiple procedures | $181.97 | $229.09 | $275.42 |
Where South Carolina sits
The same service costs 3.9 times more in Alaska than in Utah. 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
$427
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.