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 $147.91 Median $4,897.79 Typical High $21,877.62 | Facility | None | $147.91 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $223.87 | Professional | None | $138.04 | $194.98 | $223.87 |
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 $109.65 Median $186.21 Typical High $269.15 | Professional | None | $109.65 | $186.21 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $147.91 Typical High $234.42 | Facility | None | $75.86 | $147.91 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $263.03 | Professional | None | $123.03 | $169.82 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $199.53 Typical High $281.84 | Facility | None | $128.82 | $199.53 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $245.47 | Professional | None | $181.97 | $239.88 | $245.47 |
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 $123.03 Median $177.83 Typical High $323.59 | Professional | None | $123.03 | $177.83 | $323.59 |
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 $74.13 Median $74.13 Typical High $112.20 | Professional | 52 · Reduced service | $74.13 | $74.13 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $45.71 | Professional | 53 · Discontinued | $29.51 | $29.51 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $169.82 | Professional | 54 · Surgery only | $112.20 | $112.20 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $33.88 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $104.71 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $104.71 | $104.71 | $158.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $120.23 Typical High $147.91 | Professional | 51 · Multiple procedures | $91.20 | $120.23 | $147.91 |
Where South Carolina sits
The same service costs 3.5 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· 33rd of 51
$195
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.