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 $331.13 Median $5,623.41 Typical High $21,877.62 | Facility | None | $331.13 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $489.78 | Professional | None | $323.59 | $389.05 | $489.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,388.44 Median $5,888.44 Typical High $10,232.93 | Facility | None | $3,388.44 | $5,888.44 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $257.04 Median $446.68 Typical High $478.63 | Professional | None | $257.04 | $446.68 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $549.54 Typical High $1,318.26 | Facility | None | $309.03 | $549.54 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $660.69 | Professional | None | $363.08 | $467.74 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $489.78 Typical High $630.96 | Facility | None | $309.03 | $489.78 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $575.44 | Professional | None | $436.52 | $501.19 | $575.44 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $234.42 Typical High $524.81 | Professional | None | $37.15 | $234.42 | $524.81 |
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 $251.19 Median $398.11 Typical High $660.69 | Professional | None | $251.19 | $398.11 | $660.69 |
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 $181.97 Typical High $245.47 | Professional | 52 · Reduced service | $162.18 | $181.97 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $97.72 | Professional | 53 · Discontinued | $66.07 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $54.95 Typical High $74.13 | Professional | 55 · Aftercare only | $48.98 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $48.98 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $346.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $851.14 Typical High $1,148.15 | Professional | 50 · Both sides | $660.69 | $851.14 | $1,148.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $288.40 Typical High $380.19 | Professional | 51 · Multiple procedures | $218.78 | $288.40 | $380.19 |
Where South Carolina sits
The same service costs 4.7 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· 36th of 51
$407
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.