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 $123.03 Median $5,623.41 Typical High $21,877.62 | Facility | None | $123.03 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $186.21 | Professional | None | $123.03 | $186.21 | $186.21 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,511.89 Median $4,365.16 Typical High $7,585.78 | Facility | None | $2,511.89 | $4,365.16 | $7,585.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $316.23 | Professional | None | $169.82 | $218.78 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $213.80 Typical High $338.84 | Facility | None | $75.86 | $213.80 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $380.19 | Professional | None | $213.80 | $269.15 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $165.96 Median $229.09 Typical High $323.59 | Facility | None | $165.96 | $229.09 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $331.13 | Professional | None | $229.09 | $316.23 | $331.13 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $263.03 Typical High $389.05 | Professional | None | $36.31 | $263.03 | $389.05 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $426.58 | Professional | None | $158.49 | $245.47 | $426.58 |
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 $61.66 Median $87.10 Typical High $93.33 | Professional | 52 · Reduced service | $61.66 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $34.67 Typical High $38.02 | Professional | 53 · Discontinued | $24.55 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $128.82 Typical High $141.25 | Professional | 54 · Surgery only | $93.33 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $25.70 Typical High $28.18 | Professional | 55 · Aftercare only | $18.62 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.38 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.30 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $120.23 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $87.10 | $120.23 | $131.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $158.49 Typical High $204.17 | Professional | 51 · Multiple procedures | $114.82 | $158.49 | $204.17 |
Where South Carolina sits
The same service costs 3.5 times more in Alaska than in Texas. 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
$263
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.