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 $2,691.53 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,691.53 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,691.53 | $2,691.53 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,778.28 Median $3,090.30 Typical High $4,677.35 | Professional | None | $1,778.28 | $3,090.30 | $4,677.35 |
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 $2,290.87 Median $2,630.27 Typical High $4,570.88 | Professional | None | $2,290.87 | $2,630.27 | $4,570.88 |
Medcost Setting Facility Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $5,370.32 | Facility | None | $1,905.46 | $2,691.53 | $5,370.32 |
Medcost Setting Professional Modifier None Typical Low $2,511.89 Median $3,235.94 Typical High $3,388.44 | Professional | None | $2,511.89 | $3,235.94 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,778.28 Typical High $3,235.94 | Professional | None | $165.96 | $1,778.28 | $3,235.94 |
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 $1,949.84 Median $2,884.03 Typical High $4,897.79 | Professional | None | $1,949.84 | $2,884.03 | $4,897.79 |
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 $977.24 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $977.24 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $389.05 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,445.44 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $288.40 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $194.98 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,905.46 | $1,905.46 |
Where South Carolina sits
The same service costs 5.8 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· 47th of 51
$1,950
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.