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 $1,071.52 Median $22,908.68 Typical High $131,825.67 | Facility | None | $1,071.52 | $22,908.68 | $131,825.67 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,071.52 | Professional | None | $758.58 | $1,071.52 | $1,071.52 |
BCBS South Carolina Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,380.38 | Professional | None | $741.31 | $831.76 | $1,380.38 |
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 $851.14 Median $1,047.13 Typical High $1,819.70 | Professional | None | $851.14 | $1,047.13 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,071.52 Typical High $2,089.30 | Facility | None | $741.31 | $1,071.52 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,258.93 | Professional | None | $954.99 | $1,096.48 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $851.14 Typical High $1,380.38 | Professional | None | $81.28 | $851.14 | $1,380.38 |
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 $758.58 Median $1,096.48 Typical High $1,905.46 | Professional | None | $758.58 | $1,096.48 | $1,905.46 |
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 $380.19 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $380.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $151.36 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $575.44 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $114.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $75.86 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $537.03 | $741.31 | $741.31 |
Where South Carolina sits
The same service costs 4.6 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
$891
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.