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 $169.82 Median $5,623.41 Typical High $21,877.62 | Facility | None | $169.82 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $245.47 | Professional | None | $165.96 | $194.98 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $204.17 | Professional | None | $194.98 | $194.98 | $204.17 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,174.90 Typical High $2,041.74 | Facility | None | $676.08 | $1,174.90 | $2,041.74 |
BCBS South Carolina Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $281.84 | Professional | None | $131.83 | $213.80 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $389.05 Typical High $707.95 | Facility | None | $177.83 | $389.05 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $338.84 | Professional | None | $165.96 | $218.78 | $338.84 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $229.09 Typical High $295.12 | Facility | None | $144.54 | $229.09 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $331.13 | Professional | None | $213.80 | $234.42 | $331.13 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $346.74 | Professional | None | $173.78 | $239.88 | $346.74 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,606.93 | Facility | None | $302.00 | $1,122.02 | $6,606.93 |
United Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $316.23 | Professional | None | $125.89 | $186.21 | $316.23 |
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 $83.18 Median $91.20 Typical High $123.03 | Professional | 52 · Reduced service | $83.18 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $36.31 Typical High $48.98 | Professional | 53 · Discontinued | $33.88 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $138.04 Typical High $186.21 | Professional | 54 · Surgery only | $125.89 | $138.04 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $27.54 Typical High $37.15 | Professional | 55 · Aftercare only | $25.12 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.20 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.98 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $128.82 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $117.49 | $128.82 | $173.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $125.89 Typical High $204.17 | Professional | 51 · Multiple procedures | $112.20 | $125.89 | $204.17 |
Where South Carolina sits
The same service costs 3.5 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
$219
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.