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 $1,862.09 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,862.09 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,862.09 | $1,862.09 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,778.28 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $3,162.28 | Professional | None | $1,479.11 | $1,737.80 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $3,630.78 | Facility | None | $1,174.90 | $1,862.09 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,698.24 | $1,862.09 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $1,258.93 Typical High $2,290.87 | Professional | None | $125.89 | $1,258.93 | $2,290.87 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,318.26 | $1,949.84 | $3,311.31 |
6 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 $660.69 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $660.69 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $263.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,000.00 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $199.53 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $131.83 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $933.25 | $1,288.25 | $1,288.25 |
Where South Carolina sits
The same service costs 5.4 times more in Alaska than in Texas. 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· 45th of 51
$1,380
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.