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 $302.00 Median $4,897.79 Typical High $21,877.62 | Facility | None | $302.00 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $346.74 | Professional | None | $263.03 | $302.00 | $346.74 |
BCBS South Carolina Setting Facility Modifier None Typical Low $251.19 Median $436.52 Typical High $758.58 | Facility | None | $251.19 | $436.52 | $758.58 |
BCBS South Carolina Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $338.84 | Professional | None | $239.88 | $288.40 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $245.47 | Facility | None | $75.86 | $151.36 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $478.63 | Professional | None | $251.19 | $288.40 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $112.20 Median $186.21 Typical High $407.38 | Facility | None | $112.20 | $186.21 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $398.11 | Professional | None | $302.00 | $371.54 | $398.11 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $181.97 Typical High $467.74 | Professional | None | $37.15 | $181.97 | $467.74 |
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 $208.93 Median $269.15 Typical High $426.58 | Professional | None | $208.93 | $269.15 | $426.58 |
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 $141.25 Median $151.36 Typical High $169.82 | Professional | 52 · Reduced service | $141.25 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $67.61 | Professional | 53 · Discontinued | $56.23 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $208.93 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $45.71 Typical High $50.12 | Professional | 55 · Aftercare only | $42.66 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $208.93 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $194.98 | $208.93 | $234.42 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $562.34 Typical High $776.25 | Professional | 50 · Both sides | $457.09 | $562.34 | $776.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $151.36 Median $186.21 Typical High $263.03 | Professional | 51 · Multiple procedures | $151.36 | $186.21 | $263.03 |
Where South Carolina sits
The same service costs 5.4 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· 36th of 51
$288
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.