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 $354.81 Median $933.25 Typical High $16,595.87 | Facility | None | $354.81 | $933.25 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $436.52 | Professional | None | $302.00 | $354.81 | $436.52 |
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 $288.40 Median $323.59 Typical High $407.38 | Professional | None | $288.40 | $323.59 | $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 $323.59 Median $363.08 Typical High $575.44 | Professional | None | $323.59 | $363.08 | $575.44 |
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 $331.13 Median $389.05 Typical High $467.74 | Professional | None | $331.13 | $389.05 | $467.74 |
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 $257.04 Median $331.13 Typical High $524.81 | Professional | None | $257.04 | $331.13 | $524.81 |
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 $162.18 Median $177.83 Typical High $190.55 | Professional | 52 · Reduced service | $162.18 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $70.79 Typical High $77.62 | Professional | 53 · Discontinued | $66.07 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $288.40 | Professional | 54 · Surgery only | $245.47 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $57.54 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $269.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $707.95 Typical High $891.25 | Professional | 50 · Both sides | $501.19 | $707.95 | $891.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $234.42 Typical High $302.00 | Professional | 51 · Multiple procedures | $165.96 | $234.42 | $302.00 |
Where South Carolina sits
The same service costs 5.9 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· 38th of 51
$331
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.