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 $72.44 Median $4,365.16 Typical High $16,595.87 | Facility | None | $72.44 | $4,365.16 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $123.03 Typical High $181.97 | Professional | None | $72.44 | $123.03 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
BCBS South Carolina Setting Facility Modifier None Typical Low $316.23 Median $660.69 Typical High $1,445.44 | Facility | None | $316.23 | $660.69 | $1,445.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $100.00 Median $177.83 Typical High $218.78 | Professional | None | $100.00 | $177.83 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $147.91 Typical High $234.42 | Facility | None | $75.86 | $147.91 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $295.12 | Professional | None | $138.04 | $190.55 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $81.28 Typical High $263.03 | Facility | None | $61.66 | $81.28 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $239.88 | Professional | None | $147.91 | $213.80 | $239.88 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $288.40 | Professional | None | $131.83 | $194.98 | $288.40 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $288.40 | Professional | None | $100.00 | $165.96 | $288.40 |
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 $36.31 Median $60.26 Typical High $61.66 | Professional | 52 · Reduced service | $36.31 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $23.99 Typical High $24.55 | Professional | 53 · Discontinued | $14.45 | $23.99 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $89.13 Typical High $91.20 | Professional | 54 · Surgery only | $54.95 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $17.78 Typical High $18.20 | Professional | 55 · Aftercare only | $10.96 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $12.02 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.24 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $83.18 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $51.29 | $83.18 | $85.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $120.23 Typical High $131.83 | Professional | 51 · Multiple procedures | $74.13 | $120.23 | $131.83 |
Where South Carolina sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$178
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.