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 $128.82 Median $4,897.79 Typical High $21,877.62 | Facility | None | $128.82 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $194.98 | Professional | None | $123.03 | $165.96 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $95.50 Median $194.98 Typical High $245.47 | Professional | None | $95.50 | $194.98 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $125.89 Typical High $199.53 | Facility | None | $75.86 | $125.89 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $229.09 | Professional | None | $104.71 | $144.54 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $190.55 Typical High $245.47 | Facility | None | $123.03 | $190.55 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $234.42 | Professional | None | $154.88 | $204.17 | $234.42 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $245.47 | Professional | None | $131.83 | $173.78 | $245.47 |
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 $107.15 Median $151.36 Typical High $275.42 | Professional | None | $107.15 | $151.36 | $275.42 |
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 $64.57 Median $64.57 Typical High $97.72 | Professional | 52 · Reduced service | $64.57 | $64.57 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $38.90 | Professional | 53 · Discontinued | $25.70 | $25.70 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $144.54 | Professional | 54 · Surgery only | $95.50 | $95.50 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $29.51 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $19.50 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $89.13 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $89.13 | $89.13 | $134.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $104.71 Typical High $128.82 | Professional | 51 · Multiple procedures | $77.62 | $104.71 | $128.82 |
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· 22nd of 51
$186
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.