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 $2,398.83 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,398.83 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,698.24 | $2,398.83 | $2,398.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,584.89 Median $2,398.83 Typical High $3,548.13 | Professional | None | $1,584.89 | $2,398.83 | $3,548.13 |
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 $1,949.84 Median $2,344.23 Typical High $4,073.80 | Professional | None | $1,949.84 | $2,344.23 | $4,073.80 |
Medcost Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $4,677.35 | Facility | None | $1,621.81 | $2,398.83 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $3,467.37 | Professional | None | $2,187.76 | $2,754.23 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,584.89 Typical High $2,884.03 | Professional | None | $165.96 | $1,584.89 | $2,884.03 |
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 $1,698.24 Median $2,511.89 Typical High $4,265.80 | Professional | None | $1,698.24 | $2,511.89 | $4,265.80 |
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 $851.14 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $851.14 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $338.84 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,288.25 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $257.04 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $169.82 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,659.59 | $1,659.59 |
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· 46th of 51
$1,738
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.