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 $3,162.28 Median $9,120.11 Typical High $22,908.68 | Facility | None | $3,162.28 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,238.72 | $3,162.28 | $3,162.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,041.74 Median $3,019.95 Typical High $4,897.79 | Professional | None | $2,041.74 | $3,019.95 | $4,897.79 |
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 $2,454.71 Median $2,754.23 Typical High $5,370.32 | Professional | None | $2,454.71 | $2,754.23 | $5,370.32 |
Medcost Setting Facility Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $6,165.95 | Facility | None | $1,905.46 | $3,162.28 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $4,265.80 | Professional | None | $2,630.27 | $3,235.94 | $4,265.80 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $2,041.74 Typical High $3,715.35 | Professional | None | $204.17 | $2,041.74 | $3,715.35 |
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 $2,238.72 Median $3,235.94 Typical High $5,623.41 | Professional | None | $2,238.72 | $3,235.94 | $5,623.41 |
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 $1,122.02 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,122.02 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $446.68 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,698.24 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $338.84 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $223.87 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,187.76 | $2,187.76 |
Where South Carolina sits
The same service costs 6.9 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· 45th of 51
$2,239
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.