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 $1,548.82 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,548.82 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,548.82 | $1,548.82 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,047.13 | $1,905.46 | $2,754.23 |
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 $1,258.93 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,548.82 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $3,090.30 | Facility | None | $1,096.48 | $1,548.82 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,862.09 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $1,071.52 Typical High $1,905.46 | Professional | None | $89.13 | $1,071.52 | $1,905.46 |
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 $1,122.02 Median $1,621.81 Typical High $2,818.38 | Professional | None | $1,122.02 | $1,621.81 | $2,818.38 |
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 $562.34 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $562.34 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $223.87 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $831.76 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $169.82 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $112.20 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $776.25 | $1,096.48 | $1,096.48 |
Where South Carolina sits
The same service costs 5.6 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
$1,148
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.