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 $331.13 Median $354.81 Typical High $21,877.62 | Facility | None | $331.13 | $354.81 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $389.05 | Professional | None | $281.84 | $331.13 | $389.05 |
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 $251.19 Median $302.00 Typical High $346.74 | Professional | None | $251.19 | $302.00 | $346.74 |
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 $281.84 Median $323.59 Typical High $524.81 | Professional | None | $281.84 | $323.59 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $208.93 Typical High $446.68 | Facility | None | $95.50 | $208.93 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $416.87 | Professional | None | $338.84 | $371.54 | $416.87 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $263.03 Typical High $457.09 | Professional | None | $38.90 | $263.03 | $457.09 |
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 $234.42 Median $302.00 Typical High $478.63 | Professional | None | $234.42 | $302.00 | $478.63 |
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 $151.36 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $151.36 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $60.26 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $245.47 Typical High $269.15 | Professional | 54 · Surgery only | $229.09 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $50.12 Typical High $53.70 | Professional | 55 · Aftercare only | $45.71 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $229.09 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $213.80 | $229.09 | $251.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $616.60 Typical High $831.76 | Professional | 50 · Both sides | $501.19 | $616.60 | $831.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $208.93 Typical High $275.42 | Professional | 51 · Multiple procedures | $169.82 | $208.93 | $275.42 |
Where South Carolina sits
The same service costs 5.5 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· 41st of 51
$302
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.