How much rates vary
Facilitymedian $1,230 · 10th to 90th $631 to $6,761Professionalmedian $661 · 10th to 90th $158 to $977
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 $660.69 Median $5,623.41 Typical High $21,877.62 | Facility | None | $660.69 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $831.76 | Professional | None | $602.56 | $741.31 | $831.76 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,288.25 Typical High $6,606.93 | Facility | None | $691.83 | $1,288.25 | $6,606.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $912.01 | Professional | None | $512.86 | $660.69 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,905.46 | Facility | None | $602.56 | $1,230.27 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,000.00 | Professional | None | $537.03 | $660.69 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $691.83 Typical High $1,479.11 | Facility | None | $588.84 | $691.83 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $912.01 | Professional | None | $707.95 | $794.33 | $912.01 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $602.56 Typical High $954.99 | Professional | None | $79.43 | $602.56 | $954.99 |
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 $524.81 Median $676.08 Typical High $1,202.26 | Professional | None | $524.81 | $676.08 | $1,202.26 |
8 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 $331.13 Median $331.13 Typical High $416.87 | Professional | 52 · Reduced service | $331.13 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $165.96 | Professional | 53 · Discontinued | $131.83 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $616.60 | Professional | 54 · Surgery only | $489.78 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $125.89 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $83.18 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $575.44 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 51 · Multiple procedures | $645.65 | $645.65 | $645.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $398.11 Typical High $549.54 | Professional | 51 · Multiple procedures | $354.81 | $398.11 | $549.54 |
Where South Carolina sits
The same service costs 4.2 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
$741
AK $2,455TX $589
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.