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 $1,698.24 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,698.24 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,698.24 | $1,698.24 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,584.89 | $2,454.71 |
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 $1,380.38 Median $1,513.56 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,513.56 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $3,388.44 | Facility | None | $1,071.52 | $1,698.24 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,778.28 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,348.96 Typical High $2,187.76 | Professional | None | $123.03 | $1,348.96 | $2,187.76 |
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 $1,202.26 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,778.28 | $3,090.30 |
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 $616.60 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $616.60 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $245.47 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $912.01 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $181.97 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $123.03 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $851.14 | $1,202.26 | $1,202.26 |
Where South Carolina sits
The same service costs 4.8 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· 40th of 51
$1,445
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.