How much rates vary
Facilitymedian $1,000 · 10th to 90th $603 to $7,079Professionalmedian $417 · 10th to 90th $93 to $617
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 $5,623.41 Typical High $21,877.62 | Facility | None | $354.81 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $524.81 | Professional | None | $346.74 | $436.52 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,288.25 Typical High $6,760.83 | Facility | None | $691.83 | $1,288.25 | $6,760.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $501.19 | Professional | None | $281.84 | $436.52 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $831.76 Typical High $1,348.96 | Facility | None | $602.56 | $831.76 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $707.95 | Professional | None | $389.05 | $512.86 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $354.81 Median $602.56 Typical High $1,202.26 | Facility | None | $354.81 | $602.56 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $630.96 | Professional | None | $478.63 | $549.54 | $630.96 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $346.74 Typical High $602.56 | Professional | None | $38.90 | $346.74 | $602.56 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $724.44 | Professional | None | $275.42 | $436.52 | $724.44 |
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 $177.83 Median $199.53 Typical High $257.04 | Professional | 52 · Reduced service | $177.83 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $104.71 | Professional | 53 · Discontinued | $70.79 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $295.12 Typical High $389.05 | Professional | 54 · Surgery only | $269.15 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $58.88 Typical High $77.62 | Professional | 55 · Aftercare only | $53.70 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $51.29 | Professional | 56 · Pre-op care only | $35.48 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $275.42 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $251.19 | $275.42 | $363.08 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $954.99 Typical High $1,202.26 | Professional | 50 · Both sides | $724.44 | $954.99 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $316.23 Typical High $398.11 | Professional | 51 · Multiple procedures | $239.88 | $316.23 | $398.11 |
Where South Carolina sits
The same service costs 4.9 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· 37th of 51
$437
AK $1,413UT $288
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.