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 $4,365.16 Median $9,120.11 Typical High $22,908.68 | Facility | None | $4,365.16 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $4,365.16 Typical High $4,365.16 | Professional | None | $3,162.28 | $4,365.16 | $4,365.16 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,884.03 Median $3,235.94 Typical High $6,025.60 | Professional | None | $2,884.03 | $3,235.94 | $6,025.60 |
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 $3,388.44 Median $3,981.07 Typical High $7,413.10 | Professional | None | $3,388.44 | $3,981.07 | $7,413.10 |
Medcost Setting Facility Modifier None Typical Low $2,398.83 Median $4,365.16 Typical High $8,709.64 | Facility | None | $2,398.83 | $4,365.16 | $8,709.64 |
Medcost Setting Professional Modifier None Typical Low $3,630.78 Median $4,073.80 Typical High $5,011.87 | Professional | None | $3,630.78 | $4,073.80 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $2,951.21 Typical High $5,248.07 | Professional | None | $263.03 | $2,951.21 | $5,248.07 |
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 $3,162.28 Median $4,265.80 Typical High $7,943.28 | Professional | None | $3,162.28 | $4,265.80 | $7,943.28 |
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 $1,548.82 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,548.82 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $630.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $2,344.23 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $467.74 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $316.23 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $3,090.30 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $2,187.76 | $3,090.30 | $3,090.30 |
Where South Carolina sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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
$3,162
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.