How much rates vary
Facilitymedian $1,514 · 10th to 90th $631 to $8,913Professionalmedian $741 · 10th to 90th $129 to $1,072
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 $870.96 Median $5,623.41 Typical High $21,877.62 | Facility | None | $870.96 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,071.52 | Professional | None | $776.25 | $870.96 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,995.26 Typical High $9,120.11 | Facility | None | $691.83 | $1,995.26 | $9,120.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,122.02 | Professional | None | $691.83 | $724.44 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,951.21 | Facility | None | $602.56 | $1,995.26 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $1,258.93 | Professional | None | $812.83 | $831.76 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $1,479.11 | Facility | None | $588.84 | $851.14 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $977.24 | Professional | None | $549.54 | $812.83 | $977.24 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $575.44 Typical High $933.25 | Professional | None | $79.43 | $575.44 | $933.25 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,348.96 | Professional | None | $616.60 | $776.25 | $1,348.96 |
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 $389.05 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $389.05 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $154.88 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $588.84 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $77.62 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $602.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $407.38 Typical High $562.34 | Professional | 51 · Multiple procedures | $275.42 | $407.38 | $562.34 |
Where South Carolina sits
The same service costs 3.5 times more in Alaska than in Georgia. 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.
Physician feeFacility fee
AK $7,038GA $2,000
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.