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 $114.82 Typical High $141.25 | Professional | None | $102.33 | $114.82 | $141.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $2,041.74 Typical High $3,548.13 | Facility | None | $1,202.26 | $2,041.74 | $3,548.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $234.42 | Professional | None | $79.43 | $125.89 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $97.72 Typical High $154.88 | Facility | None | $75.86 | $97.72 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $199.53 | Professional | None | $109.65 | $141.25 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $102.33 Typical High $245.47 | Facility | None | $75.86 | $102.33 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $398.11 | Professional | None | $134.90 | $141.25 | $398.11 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $173.78 | Professional | None | $95.50 | $117.49 | $173.78 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $190.55 | Professional | None | $75.86 | $109.65 | $190.55 |
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 $52.48 Typical High $70.79 | Professional | 52 · Reduced service | $51.29 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $28.18 | Professional | 53 · Discontinued | $20.42 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $77.62 Typical High $104.71 | Professional | 54 · Surgery only | $75.86 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $21.38 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.47 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.23 | $10.47 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $72.44 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $70.79 | $72.44 | $97.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $89.13 Typical High $194.98 | Professional | 51 · Multiple procedures | $67.61 | $89.13 | $194.98 |
Where South Carolina sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 31st 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.