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 $2,454.71 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,454.71 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,737.80 | $2,454.71 | $2,454.71 |
BCBS South Carolina Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,621.81 | $2,344.23 |
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 $1,905.46 Median $2,187.76 Typical High $4,168.69 | Professional | None | $1,905.46 | $2,187.76 | $4,168.69 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $4,786.30 | Facility | None | $1,584.89 | $2,454.71 | $4,786.30 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $2,691.53 | Professional | None | $1,819.70 | $2,344.23 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,621.81 Typical High $2,951.21 | Professional | None | $165.96 | $1,621.81 | $2,951.21 |
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 $1,737.80 Median $2,511.89 Typical High $4,365.16 | Professional | None | $1,737.80 | $2,511.89 | $4,365.16 |
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 $870.96 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $870.96 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $346.74 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,318.26 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $263.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $173.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,698.24 | $1,698.24 |
Where South Carolina sits
The same service costs 5.8 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· 44th of 51
$1,738
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.