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 $263.03 Median $5,623.41 Typical High $21,877.62 | Facility | None | $263.03 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $478.63 | Professional | None | $263.03 | $338.84 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $436.52 | Professional | None | $165.96 | $199.53 | $436.52 |
BCBS South Carolina Setting Facility Modifier None Typical Low $549.54 Median $870.96 Typical High $1,348.96 | Facility | None | $549.54 | $870.96 | $1,348.96 |
BCBS South Carolina Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $436.52 | Professional | None | $194.98 | $302.00 | $436.52 |
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 $281.84 Median $363.08 Typical High $512.86 | Professional | None | $281.84 | $363.08 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $436.52 Typical High $851.14 | Facility | None | $218.78 | $436.52 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $457.09 | Professional | None | $275.42 | $426.58 | $457.09 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $354.81 Typical High $512.86 | Professional | None | $36.31 | $354.81 | $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 $213.80 Median $323.59 Typical High $575.44 | Professional | None | $213.80 | $323.59 | $575.44 |
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 $131.83 Median $131.83 Typical High $208.93 | Professional | 52 · Reduced service | $131.83 | $131.83 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $83.18 | Professional | 53 · Discontinued | $52.48 | $52.48 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $316.23 | Professional | 54 · Surgery only | $194.98 | $194.98 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $63.10 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $41.69 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $181.97 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $181.97 | $181.97 | $295.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $213.80 Typical High $275.42 | Professional | 51 · Multiple procedures | $138.04 | $213.80 | $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· 32nd 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.