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 $346.74 Median $4,897.79 Typical High $21,877.62 | Facility | None | $346.74 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $467.74 | Professional | None | $309.03 | $346.74 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
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 $295.12 Median $371.54 Typical High $407.38 | Professional | None | $295.12 | $371.54 | $407.38 |
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 $309.03 Median $346.74 Typical High $562.34 | Professional | None | $309.03 | $346.74 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $407.38 Typical High $630.96 | Facility | None | $95.50 | $407.38 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $457.09 | Professional | None | $323.59 | $380.19 | $457.09 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $263.03 Typical High $489.78 | Professional | None | $38.90 | $263.03 | $489.78 |
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 $245.47 Median $316.23 Typical High $501.19 | Professional | None | $245.47 | $316.23 | $501.19 |
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 $158.49 Median $173.78 Typical High $190.55 | Professional | 52 · Reduced service | $158.49 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $75.86 | Professional | 53 · Discontinued | $64.57 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $263.03 Typical High $281.84 | Professional | 54 · Surgery only | $239.88 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $52.48 Typical High $56.23 | Professional | 55 · Aftercare only | $47.86 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $34.67 Typical High $38.02 | Professional | 56 · Pre-op care only | $32.36 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $245.47 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $223.87 | $245.47 | $263.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $691.83 Typical High $870.96 | Professional | 50 · Both sides | $478.63 | $691.83 | $870.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $229.09 Typical High $295.12 | Professional | 51 · Multiple procedures | $162.18 | $229.09 | $295.12 |
Where South Carolina sits
The same service costs 5.8 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· 36th of 51
$347
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.