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 $724.44 Median $5,888.44 Typical High $21,877.62 | Facility | None | $724.44 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $724.44 | Professional | None | $616.60 | $724.44 | $724.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $12,589.25 | Facility | None | $691.83 | $1,737.80 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,023.29 | Professional | None | $575.44 | $741.31 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,511.89 | Facility | None | $602.56 | $1,778.28 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,122.02 | Professional | None | $707.95 | $707.95 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $724.44 Typical High $1,737.80 | Facility | None | $562.34 | $724.44 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $741.31 Typical High $933.25 | Professional | None | $724.44 | $741.31 | $933.25 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $354.81 Typical High $794.33 | Professional | None | $77.62 | $354.81 | $794.33 |
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 $512.86 Median $660.69 Typical High $1,071.52 | Professional | None | $512.86 | $660.69 | $1,071.52 |
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 $309.03 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $467.74 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $93.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $436.52 | $512.86 | $512.86 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,348.96 Typical High $1,698.24 | Professional | 50 · Both sides | $1,071.52 | $1,348.96 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $446.68 Typical High $562.34 | Professional | 51 · Multiple procedures | $363.08 | $446.68 | $562.34 |
Where South Carolina sits
The same service costs 18.6 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· 39th of 51
$708
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.