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 $302.00 Median $4,365.16 Typical High $16,595.87 | Facility | None | $302.00 | $4,365.16 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $398.11 | Professional | None | $295.12 | $346.74 | $398.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $426.58 Median $741.31 Typical High $1,258.93 | Facility | None | $426.58 | $741.31 | $1,258.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $489.78 | Professional | None | $229.09 | $346.74 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $398.11 Typical High $707.95 | Facility | None | $234.42 | $398.11 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $467.74 | Professional | None | $288.40 | $338.84 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $288.40 Typical High $407.38 | Facility | None | $147.91 | $288.40 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $407.38 | Professional | None | $316.23 | $389.05 | $407.38 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $257.04 Typical High $407.38 | Professional | None | $38.02 | $257.04 | $407.38 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $575.44 | Professional | None | $234.42 | $309.03 | $575.44 |
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 $147.91 Median $147.91 Typical High $186.21 | Professional | 52 · Reduced service | $147.91 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $74.13 | Professional | 53 · Discontinued | $60.26 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $275.42 | Professional | 54 · Surgery only | $223.87 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $56.23 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $257.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $204.17 Typical High $245.47 | Professional | 51 · Multiple procedures | $158.49 | $204.17 | $245.47 |
Where South Carolina sits
The same service costs 4.7 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· 38th of 51
$331
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.