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 $707.95 Median $9,120.11 Typical High $21,877.62 | Facility | None | $707.95 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $870.96 | Professional | None | $676.08 | $741.31 | $870.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,187.76 Typical High $9,332.54 | Facility | None | $851.14 | $2,187.76 | $9,332.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $398.11 Median $660.69 Typical High $758.58 | Professional | None | $398.11 | $660.69 | $758.58 |
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 $575.44 Median $707.95 Typical High $1,047.13 | Professional | None | $575.44 | $707.95 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $851.14 Typical High $1,698.24 | Facility | None | $616.60 | $851.14 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $954.99 | Professional | None | $575.44 | $812.83 | $954.99 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $602.56 Typical High $977.24 | Professional | None | $79.43 | $602.56 | $977.24 |
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 $562.34 Median $724.44 Typical High $1,258.93 | Professional | None | $562.34 | $724.44 | $1,258.93 |
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 $354.81 Median $354.81 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $630.96 | Professional | 54 · Surgery only | $524.81 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $281.84 Median $407.38 Typical High $562.34 | Professional | 51 · Multiple procedures | $281.84 | $407.38 | $562.34 |
Where South Carolina sits
The same service costs 4.5 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· 40th of 51
$741
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.