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 $407.38 Median $1,071.52 Typical High $16,595.87 | Facility | None | $407.38 | $1,071.52 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $512.86 | Professional | None | $363.08 | $407.38 | $512.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $302.00 Median $575.44 Typical High $794.33 | Facility | None | $302.00 | $575.44 | $794.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $457.09 | Professional | None | $323.59 | $380.19 | $457.09 |
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 $363.08 Median $407.38 Typical High $645.65 | Professional | None | $363.08 | $407.38 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $436.52 Typical High $630.96 | Facility | None | $95.50 | $436.52 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $524.81 | Professional | None | $380.19 | $446.68 | $524.81 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $346.74 Typical High $616.60 | Professional | None | $38.90 | $346.74 | $616.60 |
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 $288.40 Median $371.54 Typical High $588.84 | Professional | None | $288.40 | $371.54 | $588.84 |
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 $186.21 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $186.21 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $263.03 | $288.40 | $309.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $776.25 Typical High $1,023.29 | Professional | 50 · Both sides | $562.34 | $776.25 | $1,023.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $190.55 Median $257.04 Typical High $346.74 | Professional | 51 · Multiple procedures | $190.55 | $257.04 | $346.74 |
Where South Carolina sits
The same service costs 5.1 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· 35th of 51
$407
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.