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 $239.88 Median $4,677.35 Typical High $16,595.87 | Facility | None | $239.88 | $4,677.35 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $416.87 | Professional | None | $234.42 | $331.13 | $416.87 |
BCBS South Carolina Setting Facility Modifier None Typical Low $263.03 Median $630.96 Typical High $891.25 | Facility | None | $263.03 | $630.96 | $891.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $190.55 Median $363.08 Typical High $457.09 | Professional | None | $190.55 | $363.08 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $549.54 Typical High $977.24 | Facility | None | $251.19 | $549.54 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $489.78 | Professional | None | $229.09 | $338.84 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $416.87 Typical High $851.14 | Facility | None | $61.66 | $416.87 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $436.52 | Professional | None | $295.12 | $371.54 | $436.52 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $363.08 Typical High $512.86 | Professional | None | $36.31 | $363.08 | $512.86 |
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 $190.55 Median $309.03 Typical High $524.81 | Professional | None | $190.55 | $309.03 | $524.81 |
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 $120.23 Median $120.23 Typical High $208.93 | Professional | 52 · Reduced service | $120.23 | $120.23 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $83.18 | Professional | 53 · Discontinued | $47.86 | $47.86 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $309.03 | Professional | 54 · Surgery only | $177.83 | $177.83 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $61.66 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $41.69 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $288.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $144.54 Median $186.21 Typical High $275.42 | Professional | 51 · Multiple procedures | $144.54 | $186.21 | $275.42 |
Where South Carolina sits
The same service costs 3.5 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· 27th of 51
$363
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.