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 $93.33 Median $4,897.79 Typical High $21,877.62 | Facility | None | $93.33 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $151.36 | Professional | None | $87.10 | $120.23 | $151.36 |
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 $70.79 Median $134.90 Typical High $173.78 | Professional | None | $70.79 | $134.90 | $173.78 |
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 $75.86 Median $114.82 Typical High $177.83 | Professional | None | $75.86 | $114.82 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $165.96 | Facility | None | $66.07 | $102.33 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $199.53 | Professional | None | $120.23 | $158.49 | $199.53 |
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 $75.86 Median $117.49 Typical High $199.53 | Professional | None | $75.86 | $117.49 | $199.53 |
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 $46.77 Median $46.77 Typical High $75.86 | Professional | 52 · Reduced service | $46.77 | $46.77 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $30.20 | Professional | 53 · Discontinued | $18.62 | $18.62 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $112.20 | Professional | 54 · Surgery only | $70.79 | $70.79 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $22.39 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $66.07 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $66.07 | $66.07 | $104.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $58.88 Median $83.18 Typical High $100.00 | Professional | 51 · Multiple procedures | $58.88 | $83.18 | $100.00 |
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
$135
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.