How much rates vary
Facilitymedian $955 · 10th to 90th $269 to $2,042Professionalmedian $331 · 10th to 90th $200 to $525
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 $269.15 Median $8,709.64 Typical High $20,417.38 | Facility | None | $269.15 | $8,709.64 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $489.78 | Professional | None | $269.15 | $389.05 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $371.54 Typical High $575.44 | Professional | None | $186.21 | $371.54 | $575.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,202.26 Typical High $1,905.46 | Facility | None | $691.83 | $1,202.26 | $1,905.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $416.87 | Professional | None | $199.53 | $323.59 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $602.56 Typical High $1,230.27 | Facility | None | $457.09 | $602.56 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $524.81 | Professional | None | $288.40 | $389.05 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $467.74 Typical High $1,000.00 | Facility | None | $239.88 | $467.74 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $549.54 | Professional | None | $302.00 | $446.68 | $549.54 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $346.74 Typical High $512.86 | Professional | None | $36.31 | $346.74 | $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 $218.78 Median $331.13 Typical High $616.60 | Professional | None | $218.78 | $331.13 | $616.60 |
8 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 $134.90 Median $134.90 Typical High $213.80 | Professional | 52 · Reduced service | $134.90 | $134.90 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $85.11 | Professional | 53 · Discontinued | $53.70 | $53.70 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $323.59 | Professional | 54 · Surgery only | $199.53 | $199.53 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $64.57 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $42.66 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $302.00 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $316.23 Median $371.54 Typical High $676.08 | Professional | 59 · Distinct service | $316.23 | $371.54 | $676.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $151.36 Median $234.42 Typical High $281.84 | Professional | 51 · Multiple procedures | $151.36 | $234.42 | $281.84 |
Where South Carolina sits
The same service costs 3.3 times more in Alaska than in Utah. 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· 39th of 51
$372
AK $1,000UT $302
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.