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 $181.97 Median $4,897.79 Typical High $21,877.62 | Facility | None | $181.97 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $288.40 | Professional | None | $181.97 | $229.09 | $288.40 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $3,715.35 | Facility | None | $1,258.93 | $2,187.76 | $3,715.35 |
BCBS South Carolina Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $257.04 | Professional | None | $138.04 | $194.98 | $257.04 |
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 $398.11 | Professional | None | $186.21 | $275.42 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $389.05 | Facility | None | $181.97 | $295.12 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $338.84 | Professional | None | $245.47 | $288.40 | $338.84 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $251.19 Typical High $380.19 | Professional | None | $37.15 | $251.19 | $380.19 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,606.93 | Facility | None | $302.00 | $1,122.02 | $6,606.93 |
United Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $380.19 | Professional | None | $138.04 | $223.87 | $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 $91.20 Median $107.15 Typical High $144.54 | Professional | 52 · Reduced service | $91.20 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $42.66 Typical High $57.54 | Professional | 53 · Discontinued | $36.31 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $162.18 Typical High $218.78 | Professional | 54 · Surgery only | $134.90 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $32.36 Typical High $43.65 | Professional | 55 · Aftercare only | $26.92 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $28.84 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $151.36 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $125.89 | $151.36 | $204.17 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $436.52 Typical High $676.08 | Professional | 50 · Both sides | $371.54 | $436.52 | $676.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $123.03 Median $147.91 Typical High $223.87 | Professional | 51 · Multiple procedures | $123.03 | $147.91 | $223.87 |
Where South Carolina sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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
$245
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.