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 $1,905.46 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,905.46 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,905.46 | $1,905.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,258.93 | $2,137.96 | $3,162.28 |
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 $1,513.56 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,513.56 | $1,862.09 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $1,905.46 Typical High $3,715.35 | Facility | None | $1,288.25 | $1,905.46 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $2,187.76 Typical High $2,398.83 | Professional | None | $1,698.24 | $2,187.76 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $1,288.25 Typical High $2,344.23 | Professional | None | $125.89 | $1,288.25 | $2,344.23 |
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 $1,348.96 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,949.84 | $3,388.44 |
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 $676.08 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $676.08 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $269.15 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,023.29 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $204.17 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $134.90 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $954.99 | $1,318.26 | $1,318.26 |
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· 45th of 51
$1,380
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.