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 $645.65 Median $5,888.44 Typical High $21,877.62 | Facility | None | $645.65 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $645.65 | Professional | None | $549.54 | $645.65 | $645.65 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $2,398.83 Typical High $12,589.25 | Facility | None | $691.83 | $2,398.83 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $776.25 | Professional | None | $512.86 | $588.84 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $3,548.13 | Facility | None | $602.56 | $1,995.26 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $977.24 | Professional | None | $602.56 | $602.56 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $691.83 Typical High $1,659.59 | Facility | None | $537.03 | $691.83 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $776.25 | Professional | None | $616.60 | $645.65 | $776.25 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $416.87 Typical High $724.44 | Professional | None | $79.43 | $416.87 | $724.44 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $954.99 | Professional | None | $457.09 | $588.84 | $954.99 |
8 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 $275.42 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $275.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $109.65 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $416.87 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $54.95 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $389.05 | $457.09 | $457.09 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,148.15 Typical High $1,513.56 | Professional | 50 · Both sides | $933.25 | $1,148.15 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $309.03 Median $389.05 Typical High $501.19 | Professional | 51 · Multiple procedures | $309.03 | $389.05 | $501.19 |
Where South Carolina sits
The same service costs 7.9 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· 43rd of 51
$589
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.