How much rates vary
Facilitymedian $186 · 10th to 90th $69 to $1,738Professionalmedian $63 · 10th to 90th $40 to $95
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 $58.88 Median $87.10 Typical High $10,000.00 | Facility | None | $58.88 | $87.10 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $93.33 | Professional | None | $53.70 | $70.79 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $97.72 | Professional | None | $48.98 | $75.86 | $97.72 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $223.87 Typical High $398.11 | Facility | None | $134.90 | $223.87 | $398.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $30.90 Median $47.86 Typical High $74.13 | Professional | None | $30.90 | $47.86 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $95.50 | Professional | None | $45.71 | $64.57 | $95.50 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $91.20 | Facility | None | $43.65 | $69.18 | $91.20 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $93.33 | Professional | None | $58.88 | $75.86 | $93.33 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $54.95 Typical High $97.72 | Professional | None | $32.36 | $54.95 | $97.72 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $45.71 Median $61.66 Typical High $109.65 | Professional | None | $45.71 | $61.66 | $109.65 |
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 $29.51 Median $29.51 Typical High $36.31 | Professional | 52 · Reduced service | $29.51 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $14.45 | Professional | 53 · Discontinued | $11.75 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $53.70 | Professional | 54 · Surgery only | $44.67 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $10.96 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $7.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $41.69 Median $41.69 Typical High $50.12 | Professional | 78 · Unplanned return to OR | $41.69 | $41.69 | $50.12 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $48.98 Median $53.70 Typical High $57.54 | Professional | 59 · Distinct service | $48.98 | $53.70 | $57.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $29.51 Median $42.66 Typical High $47.86 | Professional | 51 · Multiple procedures | $29.51 | $42.66 | $47.86 |
Where South Carolina sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 39th of 51
$66.07
AK $224KY $53.70
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.