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 $165.96 Median $5,623.41 Typical High $21,877.62 | Facility | None | $165.96 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $288.40 | Professional | None | $165.96 | $181.97 | $288.40 |
BCBS South Carolina Setting Facility Modifier None Typical Low $426.58 Median $741.31 Typical High $1,288.25 | Facility | None | $426.58 | $741.31 | $1,288.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $123.03 Median $213.80 Typical High $295.12 | Professional | None | $123.03 | $213.80 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $363.08 Typical High $707.95 | Facility | None | $162.18 | $363.08 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $295.12 | Professional | None | $134.90 | $190.55 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $199.53 Typical High $316.23 | Facility | None | $128.82 | $199.53 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $323.59 | Professional | None | $208.93 | $269.15 | $323.59 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $288.40 | Professional | None | $162.18 | $208.93 | $288.40 |
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 $138.04 Median $199.53 Typical High $354.81 | Professional | None | $138.04 | $199.53 | $354.81 |
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 $83.18 Median $83.18 Typical High $128.82 | Professional | 52 · Reduced service | $83.18 | $83.18 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $51.29 | Professional | 53 · Discontinued | $33.11 | $33.11 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $190.55 | Professional | 54 · Surgery only | $125.89 | $125.89 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $38.02 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $117.49 | $117.49 | $177.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $104.71 Median $162.18 Typical High $165.96 | Professional | 51 · Multiple procedures | $104.71 | $162.18 | $165.96 |
Where South Carolina sits
The same service costs 3.5 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· 34th of 51
$219
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.