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 $158.49 Median $398.11 Typical High $16,595.87 | Facility | None | $158.49 | $398.11 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $302.00 | Professional | None | $158.49 | $213.80 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $389.05 | Professional | None | $134.90 | $173.78 | $389.05 |
BCBS South Carolina Setting Facility Modifier None Typical Low $208.93 Median $354.81 Typical High $660.69 | Facility | None | $208.93 | $354.81 | $660.69 |
BCBS South Carolina Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $275.42 | Professional | None | $123.03 | $169.82 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $208.93 Typical High $338.84 | Facility | None | $75.86 | $208.93 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $331.13 | Professional | None | $165.96 | $234.42 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $158.49 Typical High $380.19 | Facility | None | $81.28 | $158.49 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $302.00 | Professional | None | $154.88 | $269.15 | $302.00 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $239.88 Typical High $346.74 | Professional | None | $36.31 | $239.88 | $346.74 |
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 $128.82 Median $208.93 Typical High $363.08 | Professional | None | $128.82 | $208.93 | $363.08 |
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 $79.43 Median $79.43 Typical High $141.25 | Professional | 52 · Reduced service | $79.43 | $79.43 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $57.54 | Professional | 53 · Discontinued | $31.62 | $31.62 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $213.80 | Professional | 54 · Surgery only | $117.49 | $117.49 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $42.66 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $28.18 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $109.65 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $109.65 | $109.65 | $199.53 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $134.90 Typical High $186.21 | Professional | 51 · Multiple procedures | $77.62 | $134.90 | $186.21 |
Where South Carolina sits
The same service costs 3.4 times more in Alaska than in Maryland. 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
$214
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.