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 $102.33 Median $4,897.79 Typical High $21,877.62 | Facility | None | $102.33 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $186.21 | Professional | None | $102.33 | $128.82 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
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 $77.62 Median $125.89 Typical High $169.82 | Professional | None | $77.62 | $125.89 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $112.20 Typical High $177.83 | Facility | None | $75.86 | $112.20 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $190.55 | Professional | None | $83.18 | $123.03 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $102.33 Typical High $204.17 | Facility | None | $72.44 | $102.33 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $177.83 | Professional | None | $128.82 | $158.49 | $177.83 |
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 $83.18 Median $125.89 Typical High $218.78 | Professional | None | $83.18 | $125.89 | $218.78 |
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 $51.29 Median $51.29 Typical High $81.28 | Professional | 52 · Reduced service | $51.29 | $51.29 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $32.36 | Professional | 53 · Discontinued | $20.89 | $20.89 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $120.23 | Professional | 54 · Surgery only | $77.62 | $77.62 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $23.99 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $72.44 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $72.44 | $72.44 | $112.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $79.43 Typical High $107.15 | Professional | 51 · Multiple procedures | $64.57 | $79.43 | $107.15 |
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· 30th of 51
$138
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.