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 $562.34 Median $4,897.79 Typical High $21,877.62 | Facility | None | $562.34 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $602.56 | Professional | None | $512.86 | $562.34 | $602.56 |
BCBS South Carolina Setting Facility Modifier None Typical Low $302.00 Median $575.44 Typical High $794.33 | Facility | None | $302.00 | $575.44 | $794.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $630.96 | Professional | None | $457.09 | $537.03 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $371.54 Typical High $707.95 | Facility | None | $151.36 | $371.54 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $891.25 | Professional | None | $512.86 | $549.54 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $501.19 Typical High $812.83 | Facility | None | $95.50 | $501.19 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $724.44 | Professional | None | $501.19 | $602.56 | $724.44 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $436.52 Typical High $741.31 | Professional | None | $79.43 | $436.52 | $741.31 |
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 $398.11 Median $512.86 Typical High $812.83 | Professional | None | $398.11 | $512.86 | $812.83 |
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 $257.04 Median $281.84 Typical High $302.00 | Professional | 52 · Reduced service | $257.04 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $120.23 | Professional | 53 · Discontinued | $102.33 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $446.68 | Professional | 54 · Surgery only | $380.19 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $89.13 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $60.26 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $416.87 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,096.48 Typical High $1,380.38 | Professional | 50 · Both sides | $758.58 | $1,096.48 | $1,380.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $363.08 Typical High $467.74 | Professional | 51 · Multiple procedures | $251.19 | $363.08 | $467.74 |
Where South Carolina sits
The same service costs 5.8 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· 37th of 51
$537
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.