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 $302.00 Median $8,709.64 Typical High $20,417.38 | Facility | None | $302.00 | $8,709.64 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $524.81 | Professional | None | $302.00 | $371.54 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $436.52 | Professional | None | $204.17 | $204.17 | $436.52 |
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 $223.87 Median $363.08 Typical High $512.86 | Professional | None | $223.87 | $363.08 | $512.86 |
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 $323.59 Median $407.38 Typical High $562.34 | Professional | None | $323.59 | $407.38 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $501.19 Typical High $1,000.00 | Facility | None | $275.42 | $501.19 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $562.34 | Professional | None | $354.81 | $478.63 | $562.34 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $380.19 Typical High $575.44 | Professional | None | $36.31 | $380.19 | $575.44 |
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 $245.47 Median $363.08 Typical High $645.65 | Professional | None | $245.47 | $363.08 | $645.65 |
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 $151.36 Median $151.36 Typical High $229.09 | Professional | 52 · Reduced service | $151.36 | $151.36 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $91.20 | Professional | 53 · Discontinued | $60.26 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $346.74 | Professional | 54 · Surgery only | $223.87 | $223.87 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $69.18 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $45.71 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $323.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $239.88 Typical High $302.00 | Professional | 51 · Multiple procedures | $177.83 | $239.88 | $302.00 |
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· 33rd of 51
$407
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.