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 $1,380.38 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,380.38 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,380.38 | $1,380.38 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $5,495.41 Typical High $16,595.87 | Facility | None | $1,905.46 | $5,495.41 | $16,595.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,778.28 | Professional | None | $891.25 | $1,096.48 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $4,897.79 | Facility | None | $602.56 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,412.54 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $5,248.07 | Facility | None | $1,047.13 | $1,380.38 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,778.28 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $1,071.52 Typical High $1,737.80 | Professional | None | $66.07 | $1,071.52 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,548.82 Typical High $2,511.89 | Professional | None | $977.24 | $1,548.82 | $2,511.89 |
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 $501.19 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $501.19 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $199.53 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $741.31 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $147.91 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $100.00 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $691.83 | $977.24 | $977.24 |
Where South Carolina sits
The same service costs 5.1 times more in Wisconsin 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
$1,230
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.