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 $1,905.46 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,905.46 | $2,691.53 | $2,691.53 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,737.80 Median $2,691.53 Typical High $4,466.84 | Professional | None | $1,737.80 | $2,691.53 | $4,466.84 |
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 $2,238.72 Median $2,570.40 Typical High $4,570.88 | Professional | None | $2,238.72 | $2,570.40 | $4,570.88 |
Medcost Setting Facility Modifier None Typical Low $1,778.28 Median $2,691.53 Typical High $5,248.07 | Facility | None | $1,778.28 | $2,691.53 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $4,073.80 | Professional | None | $2,454.71 | $3,019.95 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,737.80 Typical High $3,162.28 | Professional | None | $165.96 | $1,737.80 | $3,162.28 |
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 $1,905.46 Median $2,818.38 Typical High $4,786.30 | Professional | None | $1,905.46 | $2,818.38 | $4,786.30 |
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 $954.99 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $954.99 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $380.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,445.44 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $288.40 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $190.55 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,862.09 | $1,862.09 |
Where South Carolina sits
The same service costs 6.0 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
$1,905
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.