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 $831.76 Median $10,000.00 Typical High $21,877.62 | Facility | None | $831.76 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $831.76 | Professional | None | $724.44 | $831.76 | $831.76 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $5,370.32 Typical High $19,054.61 | Facility | None | $1,047.13 | $5,370.32 | $19,054.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $691.83 | Professional | None | $467.74 | $660.69 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,511.89 | Facility | None | $602.56 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $1,288.25 | Professional | None | $794.33 | $812.83 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $2,137.96 Typical High $3,311.31 | Facility | None | $794.33 | $2,137.96 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $977.24 | Professional | None | $724.44 | $851.14 | $977.24 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $524.81 Typical High $891.25 | Professional | None | $79.43 | $524.81 | $891.25 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $21,379.62 | Facility | None | $1,445.44 | $4,265.80 | $21,379.62 |
United Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,230.27 | Professional | None | $602.56 | $758.58 | $1,230.27 |
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 $354.81 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $354.81 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $107.15 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $588.84 | $588.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,445.44 Typical High $1,949.84 | Professional | 50 · Both sides | $1,071.52 | $1,445.44 | $1,949.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $489.78 Typical High $645.65 | Professional | 51 · Multiple procedures | $354.81 | $489.78 | $645.65 |
Where South Carolina sits
The same service costs 7.8 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· 46th of 51
$676
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.