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 $123.03 Median $181.97 Typical High $21,877.62 | Facility | None | $123.03 | $181.97 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $181.97 | Professional | None | $120.23 | $138.04 | $181.97 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $2,041.74 Typical High $3,548.13 | Facility | None | $1,202.26 | $2,041.74 | $3,548.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $69.18 Median $91.20 Typical High $147.91 | Professional | None | $69.18 | $91.20 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $281.84 Typical High $707.95 | Facility | None | $128.82 | $281.84 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $275.42 | Professional | None | $102.33 | $144.54 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $181.97 Typical High $239.88 | Facility | None | $114.82 | $181.97 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $208.93 | Professional | None | $144.54 | $173.78 | $208.93 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $251.19 | Professional | None | $128.82 | $181.97 | $251.19 |
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 $95.50 Median $147.91 Typical High $251.19 | Professional | None | $95.50 | $147.91 | $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 $60.26 Median $63.10 Typical High $89.13 | Professional | 52 · Reduced service | $60.26 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $36.31 | Professional | 53 · Discontinued | $23.99 | $25.12 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $95.50 Typical High $134.90 | Professional | 54 · Surgery only | $91.20 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $26.92 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $18.20 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $89.13 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $85.11 | $89.13 | $125.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $91.20 Typical High $131.83 | Professional | 51 · Multiple procedures | $75.86 | $91.20 | $131.83 |
Where South Carolina sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 38th of 51
$155
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.