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 $72.44 Median $4,365.16 Typical High $16,595.87 | Facility | None | $72.44 | $4,365.16 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $141.25 | Professional | None | $64.57 | $104.71 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $186.21 | Professional | None | $64.57 | $109.65 | $186.21 |
BCBS South Carolina Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $416.87 | Facility | None | $144.54 | $223.87 | $416.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $33.88 Median $58.88 Typical High $104.71 | Professional | None | $33.88 | $58.88 | $104.71 |
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 $52.48 Median $85.11 Typical High $141.25 | Professional | None | $52.48 | $85.11 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $134.90 | Facility | None | $43.65 | $69.18 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $112.20 Typical High $128.82 | Professional | None | $52.48 | $112.20 | $128.82 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $194.98 | Professional | None | $97.72 | $134.90 | $194.98 |
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 $58.88 Median $93.33 Typical High $154.88 | Professional | None | $58.88 | $93.33 | $154.88 |
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 $36.31 Median $36.31 Typical High $60.26 | Professional | 52 · Reduced service | $36.31 | $36.31 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $24.55 | Professional | 53 · Discontinued | $14.45 | $14.45 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $91.20 | Professional | 54 · Surgery only | $53.70 | $53.70 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $18.20 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $50.12 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $50.12 | $50.12 | $85.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.30 Median $56.23 Typical High $79.43 | Professional | 51 · Multiple procedures | $26.30 | $56.23 | $79.43 |
Where South Carolina sits
The same service costs 3.9 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· 44th of 51
$100
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.