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 $181.97 Median $426.58 Typical High $10,000.00 | Facility | None | $181.97 | $426.58 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $338.84 | Professional | None | $181.97 | $263.03 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $489.78 | Professional | None | $158.49 | $239.88 | $489.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $213.80 Median $389.05 Typical High $776.25 | Facility | None | $213.80 | $389.05 | $776.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $309.03 | Professional | None | $144.54 | $194.98 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $223.87 Typical High $363.08 | Facility | None | $75.86 | $223.87 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $354.81 | Professional | None | $177.83 | $263.03 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $239.88 Typical High $416.87 | Facility | None | $154.88 | $239.88 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $354.81 | Professional | None | $199.53 | $316.23 | $354.81 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $251.19 Typical High $389.05 | Professional | None | $33.88 | $251.19 | $389.05 |
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 $147.91 Median $223.87 Typical High $398.11 | Professional | None | $147.91 | $223.87 | $398.11 |
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 $91.20 Median $91.20 Typical High $151.36 | Professional | 52 · Reduced service | $91.20 | $91.20 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $61.66 | Professional | 53 · Discontinued | $36.31 | $36.31 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $229.09 | Professional | 54 · Surgery only | $138.04 | $138.04 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $45.71 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $30.90 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $213.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $158.49 Typical High $199.53 | Professional | 51 · Multiple procedures | $100.00 | $158.49 | $199.53 |
Where South Carolina sits
The same service costs 3.4 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· 43rd of 51
$234
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.