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 $1,071.52 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,071.52 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,071.52 | Professional | None | $758.58 | $1,071.52 | $1,071.52 |
BCBS South Carolina Setting Facility Modifier None Typical Low $812.83 Median $3,235.94 Typical High $13,489.63 | Facility | None | $812.83 | $3,235.94 | $13,489.63 |
BCBS South Carolina Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,513.56 | Professional | None | $691.83 | $1,000.00 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $812.83 Typical High $1,621.81 | Facility | None | $602.56 | $812.83 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,819.70 | Professional | None | $933.25 | $1,071.52 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $2,089.30 | Facility | None | $758.58 | $1,071.52 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,288.25 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $891.25 Typical High $1,318.26 | Professional | None | $66.07 | $891.25 | $1,318.26 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,606.93 | Facility | None | $302.00 | $1,122.02 | $6,606.93 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $2,041.74 | Professional | None | $851.14 | $1,230.27 | $2,041.74 |
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 $380.19 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $380.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $151.36 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $575.44 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $114.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $75.86 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $537.03 | $741.31 | $741.31 |
Where South Carolina sits
The same service costs 4.4 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· 36th of 51
$1,000
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.