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 $131.83 Median $4,897.79 Typical High $21,877.62 | Facility | None | $131.83 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $239.88 | Professional | None | $131.83 | $177.83 | $239.88 |
BCBS South Carolina Setting Facility Modifier None Typical Low $239.88 Median $416.87 Typical High $707.95 | Facility | None | $239.88 | $416.87 | $707.95 |
BCBS South Carolina Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $251.19 | Professional | None | $97.72 | $199.53 | $251.19 |
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 $109.65 Median $158.49 Typical High $239.88 | Professional | None | $109.65 | $158.49 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $229.09 | Facility | None | $66.07 | $102.33 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $229.09 | Professional | None | $165.96 | $208.93 | $229.09 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $288.40 | Professional | None | $134.90 | $194.98 | $288.40 |
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 $109.65 Median $162.18 Typical High $288.40 | Professional | None | $109.65 | $162.18 | $288.40 |
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 $66.07 Median $66.07 Typical High $104.71 | Professional | 52 · Reduced service | $66.07 | $66.07 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $41.69 | Professional | 53 · Discontinued | $26.30 | $26.30 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $154.88 | Professional | 54 · Surgery only | $100.00 | $100.00 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $31.62 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $20.89 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $93.33 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $93.33 | $93.33 | $144.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $104.71 Typical High $138.04 | Professional | 51 · Multiple procedures | $83.18 | $104.71 | $138.04 |
Where South Carolina sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 22nd of 51
$200
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.