How much rates vary
Facilitymedian $1,778 · 10th to 90th $661 to $7,079Professionalmedian $631 · 10th to 90th $155 to $912
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 $616.60 Median $9,120.11 Typical High $21,877.62 | Facility | None | $616.60 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $758.58 | Professional | None | $575.44 | $676.08 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $676.08 Typical High $676.08 | Professional | None | $239.88 | $676.08 | $676.08 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,137.96 Typical High $6,606.93 | Facility | None | $851.14 | $2,137.96 | $6,606.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $891.25 | Professional | None | $478.63 | $676.08 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,258.93 Typical High $2,041.74 | Facility | None | $602.56 | $1,258.93 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $912.01 | Professional | None | $524.81 | $616.60 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $741.31 Typical High $1,548.82 | Facility | None | $562.34 | $741.31 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $831.76 | Professional | None | $616.60 | $707.95 | $831.76 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $562.34 Typical High $891.25 | Professional | None | $79.43 | $562.34 | $891.25 |
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 $478.63 Median $630.96 Typical High $1,122.02 | Professional | None | $478.63 | $630.96 | $1,122.02 |
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 $302.00 Median $302.00 Typical High $380.19 | Professional | 52 · Reduced service | $302.00 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | 53 · Discontinued | $123.03 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $562.34 | Professional | 54 · Surgery only | $457.09 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $114.82 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $75.86 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $524.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $309.03 Median $354.81 Typical High $501.19 | Professional | 51 · Multiple procedures | $309.03 | $354.81 | $501.19 |
Where South Carolina sits
The same service costs 4.3 times more in Alaska than in Texas. 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· 37th of 51
$676
AK $2,291TX $537
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.