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 $60.26 Median $4,897.79 Typical High $21,877.62 | Facility | None | $60.26 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $141.25 | Professional | None | $60.26 | $107.15 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $229.09 Typical High $416.87 | Facility | None | $134.90 | $229.09 | $416.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $154.88 | Professional | None | $50.12 | $69.18 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $213.80 | Professional | None | $69.18 | $125.89 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $144.54 | Facility | None | $43.65 | $69.18 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $154.88 Typical High $186.21 | Professional | None | $77.62 | $154.88 | $186.21 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $239.88 | Professional | None | $131.83 | $169.82 | $239.88 |
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 $70.79 Median $120.23 Typical High $223.87 | Professional | None | $70.79 | $120.23 | $223.87 |
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 $30.20 Median $42.66 Typical High $53.70 | Professional | 52 · Reduced service | $30.20 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.38 Typical High $21.38 | Professional | 53 · Discontinued | $12.02 | $17.38 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $64.57 Typical High $81.28 | Professional | 54 · Surgery only | $45.71 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.88 Typical High $16.22 | Professional | 55 · Aftercare only | $9.12 | $12.88 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.71 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.03 | $8.71 | $10.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $60.26 Typical High $75.86 | Professional | 78 · Unplanned return to OR | $42.66 | $60.26 | $75.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.90 Median $77.62 Typical High $117.49 | Professional | 51 · Multiple procedures | $38.90 | $77.62 | $117.49 |
Where South Carolina sits
The same service costs 4.5 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· 45th of 51
$123
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.