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 $1,819.70 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,819.70 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,819.70 | $1,819.70 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,479.11 | $2,570.40 |
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 $1,584.89 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,584.89 | $1,819.70 | $3,090.30 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $3,548.13 | Facility | None | $1,318.26 | $1,819.70 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,621.81 | $1,862.09 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $1,288.25 Typical High $2,187.76 | Professional | None | $109.65 | $1,288.25 | $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 $1,288.25 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,288.25 | $2,041.74 | $3,235.94 |
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 $645.65 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $645.65 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $257.04 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $977.24 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $194.98 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $128.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $912.01 | $1,258.93 | $1,258.93 |
Where South Carolina sits
The same service costs 4.9 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· 42nd of 51
$1,413
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.