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 $120.23 Median $4,897.79 Typical High $21,877.62 | Facility | None | $120.23 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $218.78 | Professional | None | $114.82 | $154.88 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $251.19 | Professional | None | $138.04 | $147.91 | $251.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $239.88 Median $407.38 Typical High $691.83 | Facility | None | $239.88 | $407.38 | $691.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $89.13 Median $169.82 Typical High $213.80 | Professional | None | $89.13 | $169.82 | $213.80 |
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 $97.72 Median $141.25 Typical High $223.87 | Professional | None | $97.72 | $141.25 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $213.80 | Facility | None | $66.07 | $102.33 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $204.17 | Professional | None | $147.91 | $190.55 | $204.17 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $245.47 | Professional | None | $131.83 | $173.78 | $245.47 |
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 $100.00 Median $147.91 Typical High $263.03 | Professional | None | $100.00 | $147.91 | $263.03 |
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 $60.26 Median $60.26 Typical High $95.50 | Professional | 52 · Reduced service | $60.26 | $60.26 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $38.90 | Professional | 53 · Discontinued | $23.99 | $23.99 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $144.54 | Professional | 54 · Surgery only | $89.13 | $89.13 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $28.84 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $19.50 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $83.18 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $83.18 | $83.18 | $134.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $95.50 Typical High $125.89 | Professional | 51 · Multiple procedures | $74.13 | $95.50 | $125.89 |
Where South Carolina sits
The same service costs 3.4 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· 28th of 51
$170
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.