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 $1,621.81 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,621.81 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,621.81 | $1,621.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,905.46 | $2,754.23 |
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 $1,318.26 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,584.89 | $2,754.23 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,621.81 Typical High $3,162.28 | Facility | None | $1,122.02 | $1,621.81 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,905.46 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $1,122.02 Typical High $1,995.26 | Professional | None | $89.13 | $1,122.02 | $1,995.26 |
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 $1,148.15 Median $1,698.24 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,698.24 | $2,884.03 |
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 $575.44 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $575.44 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $229.09 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $870.96 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $173.78 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $114.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $812.83 | $1,122.02 | $1,122.02 |
Where South Carolina sits
The same service costs 5.5 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
$1,230
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.