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 $199.53 Median $4,897.79 Typical High $21,877.62 | Facility | None | $199.53 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $309.03 | Professional | None | $199.53 | $234.42 | $309.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $3,467.37 | Facility | None | $512.86 | $870.96 | $3,467.37 |
BCBS South Carolina Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $323.59 | Professional | None | $151.36 | $234.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $812.83 Typical High $1,348.96 | Facility | None | $457.09 | $812.83 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $426.58 | Professional | None | $199.53 | $295.12 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $416.87 Typical High $741.31 | Facility | None | $162.18 | $416.87 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $371.54 | Professional | None | $257.04 | $309.03 | $371.54 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $263.03 Typical High $398.11 | Professional | None | $35.48 | $263.03 | $398.11 |
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 $151.36 Median $239.88 Typical High $407.38 | Professional | None | $151.36 | $239.88 | $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 $100.00 Median $114.82 Typical High $154.88 | Professional | 52 · Reduced service | $100.00 | $114.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $45.71 Typical High $61.66 | Professional | 53 · Discontinued | $39.81 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $173.78 Typical High $234.42 | Professional | 54 · Surgery only | $151.36 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $34.67 Typical High $46.77 | Professional | 55 · Aftercare only | $30.20 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $22.91 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.95 | $22.91 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $162.18 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $141.25 | $162.18 | $218.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $467.74 Typical High $724.44 | Professional | 50 · Both sides | $389.05 | $467.74 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $154.88 Typical High $239.88 | Professional | 51 · Multiple procedures | $128.82 | $154.88 | $239.88 |
Where South Carolina sits
The same service costs 4.1 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· 32nd of 51
$275
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.