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 $53.70 Median $57.54 Typical High $21,877.62 | Facility | None | $53.70 | $57.54 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $57.54 | Professional | None | $47.86 | $53.70 | $57.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $223.87 Typical High $416.87 | Facility | None | $134.90 | $223.87 | $416.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $52.48 | Professional | None | $40.74 | $50.12 | $52.48 |
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 $40.74 Median $51.29 Typical High $72.44 | Professional | None | $40.74 | $51.29 | $72.44 |
Medcost Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Medcost Setting Facility Modifier None Typical Low $23.99 Median $39.81 Typical High $72.44 | Facility | None | $23.99 | $39.81 | $72.44 |
Medcost Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $60.26 | Professional | None | $45.71 | $51.29 | $60.26 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $114.82 | Professional | None | $64.57 | $79.43 | $114.82 |
United Setting Facility Modifier None Typical Low $83.18 Median $380.19 Typical High $2,238.72 | Facility | None | $83.18 | $380.19 | $2,238.72 |
United Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $85.11 | Professional | None | $38.02 | $50.12 | $85.11 |
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 $25.70 Median $26.92 Typical High $28.84 | Professional | 52 · Reduced service | $25.70 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.72 Typical High $11.48 | Professional | 53 · Discontinued | $10.23 | $10.72 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $40.74 Typical High $42.66 | Professional | 54 · Surgery only | $38.02 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.13 Typical High $8.51 | Professional | 55 · Aftercare only | $7.59 | $8.13 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.37 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.13 | $5.37 | $5.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $35.48 Median $38.02 Typical High $39.81 | Professional | 78 · Unplanned return to OR | $35.48 | $38.02 | $39.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.91 Median $25.70 Typical High $38.02 | Professional | 51 · Multiple procedures | $22.91 | $25.70 | $38.02 |
Where South Carolina sits
The same service costs 4.6 times more in Alaska than in New York. 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· 35th of 51
$53.70
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.