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 $676.08 Median $5,888.44 Typical High $21,877.62 | Facility | None | $676.08 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $676.08 | Professional | None | $575.44 | $676.08 | $676.08 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $2,187.76 Typical High $12,589.25 | Facility | None | $691.83 | $2,187.76 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $933.25 | Professional | None | $537.03 | $758.58 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $3,162.28 | Facility | None | $602.56 | $1,995.26 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,047.13 | Professional | None | $645.65 | $660.69 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $741.31 Typical High $1,659.59 | Facility | None | $537.03 | $741.31 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,412.54 | Professional | None | $676.08 | $776.25 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $416.87 Typical High $758.58 | Professional | None | $79.43 | $416.87 | $758.58 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,000.00 | Professional | None | $478.63 | $616.60 | $1,000.00 |
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 $288.40 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $288.40 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $114.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $436.52 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $87.10 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $57.54 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $407.38 | $478.63 | $478.63 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,445.44 Typical High $2,137.96 | Professional | 50 · Both sides | $1,047.13 | $1,445.44 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $346.74 Median $489.78 Typical High $707.95 | Professional | 51 · Multiple procedures | $346.74 | $489.78 | $707.95 |
Where South Carolina sits
The same service costs 7.9 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· 42nd of 51
$617
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.