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 $831.76 Median $10,000.00 Typical High $21,877.62 | Facility | None | $831.76 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $831.76 | Professional | None | $707.95 | $831.76 | $831.76 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $8,912.51 | Facility | None | $851.14 | $2,818.38 | $8,912.51 |
BCBS South Carolina Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $891.25 | Professional | None | $645.65 | $794.33 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,511.89 | Facility | None | $602.56 | $1,778.28 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,148.15 | Professional | None | $676.08 | $831.76 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $831.76 Typical High $1,995.26 | Facility | None | $616.60 | $831.76 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,000.00 | Professional | None | $831.76 | $954.99 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $575.44 Typical High $912.01 | Professional | None | $114.82 | $575.44 | $912.01 |
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 $588.84 Median $776.25 Typical High $1,202.26 | Professional | None | $588.84 | $776.25 | $1,202.26 |
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 $354.81 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $354.81 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $141.25 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $107.15 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $70.79 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $588.84 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $501.19 Typical High $645.65 | Professional | 51 · Multiple procedures | $426.58 | $501.19 | $645.65 |
Where South Carolina sits
The same service costs 6.6 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· 40th of 51
$759
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.