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 $1,995.26 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,995.26 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,995.26 | $1,995.26 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,348.96 Median $2,398.83 Typical High $3,467.37 | Professional | None | $1,348.96 | $2,398.83 | $3,467.37 |
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 $1,621.81 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,621.81 | $1,949.84 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,995.26 Typical High $3,981.07 | Facility | None | $1,380.38 | $1,995.26 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,819.70 | $2,344.23 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $1,348.96 Typical High $2,454.71 | Professional | None | $125.89 | $1,348.96 | $2,454.71 |
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 $1,412.54 Median $2,041.74 Typical High $3,548.13 | Professional | None | $1,412.54 | $2,041.74 | $3,548.13 |
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 $707.95 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $707.95 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $281.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,071.52 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $213.80 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $141.25 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,412.54 | $1,412.54 |
Where South Carolina sits
The same service costs 5.9 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
$1,479
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.