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 $131.83 Median $4,897.79 Typical High $21,877.62 | Facility | None | $131.83 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $218.78 | Professional | None | $117.49 | $173.78 | $218.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $851.14 Typical High $1,584.89 | Facility | None | $501.19 | $851.14 | $1,584.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $177.83 | Professional | None | $81.28 | $102.33 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $147.91 Typical High $234.42 | Facility | None | $75.86 | $147.91 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $331.13 | Professional | None | $109.65 | $177.83 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $218.78 Typical High $245.47 | Facility | None | $131.83 | $218.78 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $257.04 | Professional | None | $173.78 | $208.93 | $257.04 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $302.00 | Professional | None | $134.90 | $204.17 | $302.00 |
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 $102.33 Median $169.82 Typical High $295.12 | Professional | None | $102.33 | $169.82 | $295.12 |
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 $64.57 Median $67.61 Typical High $109.65 | Professional | 52 · Reduced service | $64.57 | $67.61 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.92 Typical High $44.67 | Professional | 53 · Discontinued | $25.70 | $26.92 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $102.33 Typical High $165.96 | Professional | 54 · Surgery only | $95.50 | $102.33 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.42 Typical High $33.11 | Professional | 55 · Aftercare only | $19.05 | $20.42 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.88 | $13.49 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $95.50 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $89.13 | $95.50 | $154.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $338.84 Typical High $489.78 | Professional | 50 · Both sides | $257.04 | $338.84 | $489.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $114.82 Typical High $162.18 | Professional | 51 · Multiple procedures | $85.11 | $114.82 | $162.18 |
Where South Carolina sits
The same service costs 4.5 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· 37th of 51
$178
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.