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 $177.83 Median $4,265.80 Typical High $16,595.87 | Facility | None | $177.83 | $4,265.80 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $302.00 | Professional | None | $177.83 | $239.88 | $302.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,288.25 Typical High $6,760.83 | Facility | None | $676.08 | $1,288.25 | $6,760.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $257.04 | Professional | None | $138.04 | $186.21 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $812.83 Typical High $1,348.96 | Facility | None | $457.09 | $812.83 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $407.38 | Professional | None | $181.97 | $275.42 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $691.83 Typical High $1,071.52 | Facility | None | $177.83 | $691.83 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $354.81 | Professional | None | $275.42 | $302.00 | $354.81 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $263.03 Typical High $398.11 | Professional | None | $35.48 | $263.03 | $398.11 |
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 $134.90 Median $223.87 Typical High $380.19 | Professional | None | $134.90 | $223.87 | $380.19 |
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 $89.13 Median $112.20 Typical High $151.36 | Professional | 52 · Reduced service | $89.13 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $44.67 Typical High $60.26 | Professional | 53 · Discontinued | $35.48 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $169.82 Typical High $229.09 | Professional | 54 · Surgery only | $134.90 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $33.88 Typical High $45.71 | Professional | 55 · Aftercare only | $26.92 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $22.39 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.78 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $158.49 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $125.89 | $158.49 | $213.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $144.54 Median $162.18 Typical High $234.42 | Professional | 51 · Multiple procedures | $144.54 | $162.18 | $234.42 |
Where South Carolina sits
The same service costs 4.5 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
$257
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.