How much rates vary
Facilitymedian $1,905 · 10th to 90th $851 to $10,471Professionalmedian $380 · 10th to 90th $89 to $631
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 $10,471.29 Typical High $21,877.62 | Facility | None | $323.59 | $10,471.29 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $478.63 | Professional | None | $316.23 | $380.19 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $2,884.03 Typical High $8,912.51 | Facility | None | $1,047.13 | $2,884.03 | $8,912.51 |
BCBS South Carolina Setting Professional Modifier None Typical Low $251.19 Median $436.52 Typical High $691.83 | Professional | None | $251.19 | $436.52 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $2,818.38 | Facility | None | $630.96 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $660.69 | Professional | None | $354.81 | $489.78 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $323.59 Median $794.33 Typical High $1,202.26 | Facility | None | $323.59 | $794.33 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $630.96 | Professional | None | $478.63 | $537.03 | $630.96 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $295.12 Typical High $512.86 | Professional | None | $38.90 | $295.12 | $512.86 |
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 $407.38 Typical High $691.83 | Professional | None | $245.47 | $407.38 | $691.83 |
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 $234.42 | Professional | 52 · Reduced service | $162.18 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $95.50 | Professional | 53 · Discontinued | $64.57 | $70.79 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $269.15 Typical High $354.81 | Professional | 54 · Surgery only | $239.88 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $53.70 Typical High $70.79 | Professional | 55 · Aftercare only | $47.86 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $47.86 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $251.19 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $223.87 | $251.19 | $331.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $891.25 Typical High $1,096.48 | Professional | 50 · Both sides | $741.31 | $891.25 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $295.12 Typical High $363.08 | Professional | 51 · Multiple procedures | $245.47 | $295.12 | $363.08 |
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· 39th of 51
$407
AK $1,413UT $240
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.