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 $165.96 Median $4,897.79 Typical High $21,877.62 | Facility | None | $165.96 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $186.21 | Professional | None | $144.54 | $165.96 | $186.21 |
BCBS South Carolina Setting Facility Modifier None Typical Low $251.19 Median $426.58 Typical High $758.58 | Facility | None | $251.19 | $426.58 | $758.58 |
BCBS South Carolina Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $181.97 | Professional | None | $128.82 | $151.36 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $134.90 Typical High $213.80 | Facility | None | $75.86 | $134.90 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $275.42 | Professional | None | $158.49 | $169.82 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $128.82 Typical High $234.42 | Facility | None | $95.50 | $128.82 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $218.78 | Professional | None | $162.18 | $186.21 | $218.78 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $138.04 Typical High $251.19 | Professional | None | $37.15 | $138.04 | $251.19 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $251.19 | Professional | None | $117.49 | $158.49 | $251.19 |
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 $79.43 Median $83.18 Typical High $93.33 | Professional | 52 · Reduced service | $79.43 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.11 Typical High $38.02 | Professional | 53 · Discontinued | $31.62 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $123.03 Typical High $141.25 | Professional | 54 · Surgery only | $120.23 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $24.55 Typical High $28.18 | Professional | 55 · Aftercare only | $23.99 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.60 Typical High $18.62 | Professional | 56 · Pre-op care only | $15.85 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $114.82 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $112.20 | $114.82 | $131.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $81.28 Median $109.65 Typical High $144.54 | Professional | 51 · Multiple procedures | $81.28 | $109.65 | $144.54 |
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
$166
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.