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 $776.25 Median $10,964.78 Typical High $21,877.62 | Facility | None | $776.25 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $776.25 | Professional | None | $660.69 | $776.25 | $776.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,467.37 Median $6,918.31 Typical High $14,454.40 | Facility | None | $3,467.37 | $6,918.31 | $14,454.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,071.52 | Professional | None | $602.56 | $851.14 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,981.07 Typical High $5,623.41 | Facility | None | $602.56 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,202.26 | Professional | None | $758.58 | $758.58 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $776.25 Typical High $6,456.54 | Facility | None | $602.56 | $776.25 | $6,456.54 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $977.24 | Professional | None | $776.25 | $831.76 | $977.24 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $489.78 Typical High $851.14 | Professional | None | $79.43 | $489.78 | $851.14 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,122.02 | Professional | None | $549.54 | $691.83 | $1,122.02 |
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 $331.13 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $331.13 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $66.07 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $537.03 | $537.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,445.44 Typical High $1,778.28 | Professional | 50 · Both sides | $1,202.26 | $1,445.44 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $398.11 Median $478.63 Typical High $602.56 | Professional | 51 · Multiple procedures | $398.11 | $478.63 | $602.56 |
Where South Carolina sits
The same service costs 7.4 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· 43rd of 51
$692
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.