How much rates vary
Facilitymedian $1,778 · 10th to 90th $676 to $7,079Professionalmedian $891 · 10th to 90th $200 to $1,259
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 $831.76 Median $9,120.11 Typical High $21,877.62 | Facility | None | $831.76 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,174.90 | Professional | None | $794.33 | $954.99 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $794.33 Typical High $1,621.81 | Professional | None | $346.74 | $794.33 | $1,621.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $1,949.84 Typical High $6,606.93 | Facility | None | $851.14 | $1,949.84 | $6,606.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,380.38 | Professional | None | $630.96 | $977.24 | $1,380.38 |
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 $776.25 Median $891.25 Typical High $1,258.93 | Professional | None | $776.25 | $891.25 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $1,698.24 | Facility | None | $645.65 | $831.76 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,148.15 | Professional | None | $912.01 | $1,047.13 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $707.95 Typical High $1,122.02 | Professional | None | $117.49 | $707.95 | $1,122.02 |
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 $660.69 Median $851.14 Typical High $1,548.82 | Professional | None | $660.69 | $851.14 | $1,548.82 |
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 $416.87 Median $416.87 Typical High $501.19 | Professional | 52 · Reduced service | $416.87 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | 53 · Discontinued | $165.96 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $691.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $562.34 Typical High $660.69 | Professional | 51 · Multiple procedures | $457.09 | $562.34 | $660.69 |
Where South Carolina sits
The same service costs 4.4 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· 33rd of 51
$955
AK $3,090TX $708
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.