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 $2,884.03 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,884.03 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,884.03 | $2,884.03 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,862.09 Median $2,951.21 Typical High $4,570.88 | Professional | None | $1,862.09 | $2,951.21 | $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 $4,897.79 | Professional | None | $2,344.23 | $2,754.23 | $4,897.79 |
Medcost Setting Facility Modifier None Typical Low $1,949.84 Median $2,884.03 Typical High $5,623.41 | Facility | None | $1,949.84 | $2,884.03 | $5,623.41 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $3,388.44 | Professional | None | $2,630.27 | $3,311.31 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $2,187.76 Typical High $3,548.13 | Professional | None | $213.80 | $2,187.76 | $3,548.13 |
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 $2,041.74 Median $3,019.95 Typical High $5,128.61 | Professional | None | $2,041.74 | $3,019.95 | $5,128.61 |
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 $1,023.29 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,023.29 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $407.38 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,548.82 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $309.03 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $204.17 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,995.26 | $1,995.26 |
Where South Carolina sits
The same service costs 5.4 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· 41st 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.