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 $2,818.38 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,818.38 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,818.38 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,818.38 | $2,818.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,819.70 Median $3,090.30 Typical High $4,570.88 | Professional | None | $1,819.70 | $3,090.30 | $4,570.88 |
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 $2,344.23 Median $2,754.23 Typical High $4,786.30 | Professional | None | $2,344.23 | $2,754.23 | $4,786.30 |
Medcost Setting Facility Modifier None Typical Low $1,905.46 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,905.46 | $2,818.38 | $5,495.41 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $3,388.44 | Professional | None | $2,570.40 | $3,235.94 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $2,137.96 Typical High $3,467.37 | Professional | None | $213.80 | $2,137.96 | $3,467.37 |
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 $1,995.26 Median $3,090.30 Typical High $5,011.87 | Professional | None | $1,995.26 | $3,090.30 | $5,011.87 |
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 $1,000.00 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,000.00 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $398.11 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,479.11 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $302.00 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $199.53 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,949.84 | $1,949.84 |
Where South Carolina sits
The same service costs 5.2 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· 38th of 51
$2,344
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.