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 $426.58 Median $5,623.41 Typical High $21,877.62 | Facility | None | $426.58 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $446.68 Typical High $524.81 | Professional | None | $426.58 | $446.68 | $524.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,548.82 Typical High $10,232.93 | Facility | None | $691.83 | $1,548.82 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $478.63 | Professional | None | $288.40 | $331.13 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $2,290.87 | Facility | None | $602.56 | $1,621.81 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $851.14 | Professional | None | $354.81 | $489.78 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $602.56 Typical High $1,288.25 | Facility | None | $251.19 | $602.56 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $676.08 | Professional | None | $407.38 | $562.34 | $676.08 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $426.58 Typical High $707.95 | Professional | None | $39.81 | $426.58 | $707.95 |
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 $354.81 Median $478.63 Typical High $851.14 | Professional | None | $354.81 | $478.63 | $851.14 |
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 $213.80 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $213.80 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $89.13 Typical High $104.71 | Professional | 53 · Discontinued | $85.11 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $338.84 Typical High $389.05 | Professional | 54 · Surgery only | $316.23 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $67.61 Typical High $77.62 | Professional | 55 · Aftercare only | $63.10 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $44.67 Typical High $52.48 | Professional | 56 · Pre-op care only | $42.66 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $316.23 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $295.12 | $316.23 | $363.08 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $831.76 Typical High $1,288.25 | Professional | 50 · Both sides | $602.56 | $831.76 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $281.84 Typical High $389.05 | Professional | 51 · Multiple procedures | $199.53 | $281.84 | $389.05 |
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· 42nd of 51
$468
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.