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 $181.97 Median $4,897.79 Typical High $21,877.62 | Facility | None | $181.97 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $288.40 | Professional | None | $181.97 | $218.78 | $288.40 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $3,890.45 | Facility | None | $1,288.25 | $2,187.76 | $3,890.45 |
BCBS South Carolina Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $309.03 | Professional | None | $144.54 | $218.78 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $389.05 Typical High $707.95 | Facility | None | $199.53 | $389.05 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $389.05 | Professional | None | $190.55 | $275.42 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $288.40 Typical High $371.54 | Facility | None | $181.97 | $288.40 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $354.81 | Professional | None | $257.04 | $295.12 | $354.81 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $229.09 Typical High $346.74 | Professional | None | $35.48 | $229.09 | $346.74 |
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 $141.25 Median $223.87 Typical High $380.19 | Professional | None | $141.25 | $223.87 | $380.19 |
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 $91.20 Median $107.15 Typical High $141.25 | Professional | 52 · Reduced service | $91.20 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $42.66 Typical High $57.54 | Professional | 53 · Discontinued | $37.15 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $158.49 Typical High $213.80 | Professional | 54 · Surgery only | $138.04 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $31.62 Typical High $42.66 | Professional | 55 · Aftercare only | $27.54 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $28.84 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $147.91 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $128.82 | $147.91 | $199.53 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $512.86 Typical High $660.69 | Professional | 50 · Both sides | $389.05 | $512.86 | $660.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $169.82 Typical High $223.87 | Professional | 51 · Multiple procedures | $128.82 | $169.82 | $223.87 |
Where South Carolina sits
The same service costs 3.5 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· 34th of 51
$240
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.