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 $323.59 Median $9,120.11 Typical High $21,877.62 | Facility | None | $323.59 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $354.81 Typical High $398.11 | Professional | None | $309.03 | $354.81 | $398.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $8,912.51 | Facility | None | $851.14 | $2,238.72 | $8,912.51 |
BCBS South Carolina Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $512.86 | Professional | None | $251.19 | $363.08 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $1,584.89 | Facility | None | $602.56 | $977.24 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $562.34 | Professional | None | $346.74 | $371.54 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $323.59 Median $645.65 Typical High $1,122.02 | Facility | None | $323.59 | $645.65 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $660.69 | Professional | None | $363.08 | $416.87 | $660.69 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $229.09 Typical High $389.05 | Professional | None | $38.90 | $229.09 | $389.05 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $537.03 | Professional | None | $245.47 | $323.59 | $537.03 |
7 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 $154.88 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $154.88 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $64.57 Typical High $72.44 | Professional | 53 · Discontinued | $61.66 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $239.88 Typical High $269.15 | Professional | 54 · Surgery only | $229.09 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $53.70 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $32.36 Typical High $36.31 | Professional | 56 · Pre-op care only | $30.90 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $223.87 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $213.80 | $223.87 | $251.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $229.09 Typical High $331.13 | Professional | 51 · Multiple procedures | $199.53 | $229.09 | $331.13 |
Where South Carolina sits
The same service costs 6.8 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· 39th of 51
$324
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.