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 $186.21 Median $4,897.79 Typical High $21,877.62 | Facility | None | $186.21 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $295.12 | Professional | None | $186.21 | $218.78 | $295.12 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,511.89 Median $4,365.16 Typical High $7,762.47 | Facility | None | $2,511.89 | $4,365.16 | $7,762.47 |
BCBS South Carolina Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $302.00 | Professional | None | $141.25 | $218.78 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $707.95 | Facility | None | $208.93 | $389.05 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $407.38 | Professional | None | $186.21 | $275.42 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $398.11 | Facility | None | $151.36 | $295.12 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $354.81 | Professional | None | $239.88 | $295.12 | $354.81 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $229.09 Typical High $346.74 | Professional | None | $35.48 | $229.09 | $346.74 |
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 $141.25 Median $229.09 Typical High $380.19 | Professional | None | $141.25 | $229.09 | $380.19 |
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 $93.33 Median $109.65 Typical High $147.91 | Professional | 52 · Reduced service | $93.33 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $43.65 Typical High $58.88 | Professional | 53 · Discontinued | $37.15 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $162.18 Typical High $218.78 | Professional | 54 · Surgery only | $138.04 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $43.65 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.88 Typical High $29.51 | Professional | 56 · Pre-op care only | $18.62 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $151.36 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $128.82 | $151.36 | $204.17 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $446.68 Typical High $676.08 | Professional | 50 · Both sides | $363.08 | $446.68 | $676.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $147.91 Typical High $229.09 | Professional | 51 · Multiple procedures | $120.23 | $147.91 | $229.09 |
Where South Carolina sits
The same service costs 3.7 times more in Alaska than in Utah. 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· 37th of 51
$240
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.