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 $162.18 Median $389.05 Typical High $16,595.87 | Facility | None | $162.18 | $389.05 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $389.05 | Professional | None | $162.18 | $257.04 | $389.05 |
BCBS South Carolina Setting Facility Modifier None Typical Low $204.17 Median $354.81 Typical High $676.08 | Facility | None | $204.17 | $354.81 | $676.08 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $199.53 Typical High $346.74 | Professional | None | $104.71 | $199.53 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $125.89 Typical High $199.53 | Facility | None | $75.86 | $125.89 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $288.40 Typical High $407.38 | Professional | None | $147.91 | $288.40 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $120.23 Typical High $389.05 | Facility | None | $89.13 | $120.23 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $457.09 | Professional | None | $263.03 | $389.05 | $457.09 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $346.74 Typical High $524.81 | Professional | None | $35.48 | $346.74 | $524.81 |
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 $117.49 Median $234.42 Typical High $407.38 | Professional | None | $117.49 | $234.42 | $407.38 |
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 $81.28 Median $107.15 Typical High $194.98 | Professional | 52 · Reduced service | $81.28 | $107.15 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $42.66 Typical High $77.62 | Professional | 53 · Discontinued | $32.36 | $42.66 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $162.18 Typical High $295.12 | Professional | 54 · Surgery only | $120.23 | $162.18 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $32.36 Typical High $58.88 | Professional | 55 · Aftercare only | $23.99 | $32.36 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.38 Typical High $38.90 | Professional | 56 · Pre-op care only | $16.22 | $21.38 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $151.36 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $112.20 | $151.36 | $275.42 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 51 · Multiple procedures | $102.33 | $102.33 | $102.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $199.53 Typical High $269.15 | Professional | 51 · Multiple procedures | $131.83 | $199.53 | $269.15 |
Where South Carolina sits
The same service costs 3.6 times more in Wisconsin 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· 30th of 51
$257
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.