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 $338.84 Median $4,897.79 Typical High $21,877.62 | Facility | None | $338.84 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $354.81 | Professional | None | $288.40 | $338.84 | $354.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $794.33 Typical High $2,187.76 | Facility | None | $489.78 | $794.33 | $2,187.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $426.58 | Professional | None | $269.15 | $363.08 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $371.54 Typical High $707.95 | Facility | None | $151.36 | $371.54 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $537.03 | Professional | None | $295.12 | $316.23 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $389.05 Typical High $630.96 | Facility | None | $245.47 | $389.05 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $436.52 | Professional | None | $346.74 | $416.87 | $436.52 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $269.15 Typical High $467.74 | Professional | None | $38.90 | $269.15 | $467.74 |
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 $234.42 Median $302.00 Typical High $489.78 | Professional | None | $234.42 | $302.00 | $489.78 |
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 $151.36 Median $169.82 Typical High $177.83 | Professional | 52 · Reduced service | $151.36 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $67.61 Typical High $70.79 | Professional | 53 · Discontinued | $60.26 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $257.04 Typical High $269.15 | Professional | 54 · Surgery only | $229.09 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $53.70 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.20 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $239.88 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $213.80 | $239.88 | $251.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $173.78 Median $213.80 Typical High $275.42 | Professional | 51 · Multiple procedures | $173.78 | $213.80 | $275.42 |
Where South Carolina sits
The same service costs 5.5 times more in Alaska than in Texas. 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· 36th of 51
$324
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.