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 $302.00 Median $4,265.80 Typical High $16,595.87 | Facility | None | $302.00 | $4,265.80 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $323.59 | Professional | None | $257.04 | $302.00 | $323.59 |
BCBS South Carolina Setting Facility Modifier None Typical Low $251.19 Median $426.58 Typical High $741.31 | Facility | None | $251.19 | $426.58 | $741.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $363.08 | Professional | None | $257.04 | $323.59 | $363.08 |
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 $263.03 Median $288.40 Typical High $478.63 | Professional | None | $263.03 | $288.40 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $204.17 Typical High $407.38 | Facility | None | $95.50 | $204.17 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $436.52 | Professional | None | $269.15 | $316.23 | $436.52 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $229.09 Typical High $389.05 | Professional | None | $38.90 | $229.09 | $389.05 |
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 $208.93 Median $269.15 Typical High $436.52 | Professional | None | $208.93 | $269.15 | $436.52 |
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 $131.83 Median $151.36 Typical High $158.49 | Professional | 52 · Reduced service | $131.83 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $63.10 | Professional | 53 · Discontinued | $53.70 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $229.09 Typical High $234.42 | Professional | 54 · Surgery only | $199.53 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $45.71 Typical High $47.86 | Professional | 55 · Aftercare only | $39.81 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $213.80 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $186.21 | $213.80 | $218.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $588.84 Typical High $741.31 | Professional | 50 · Both sides | $398.11 | $588.84 | $741.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $194.98 Typical High $245.47 | Professional | 51 · Multiple procedures | $134.90 | $194.98 | $245.47 |
Where South Carolina sits
The same service costs 5.9 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· 36th of 51
$288
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.