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 $1,318.26 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,318.26 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $1,318.26 | Professional | None | $933.25 | $1,318.26 | $1,318.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $13,489.63 | Facility | None | $1,621.81 | $3,801.89 | $13,489.63 |
BCBS South Carolina Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,819.70 | Professional | None | $851.14 | $1,071.52 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,511.89 | Facility | None | $602.56 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,318.26 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $977.24 Median $1,445.44 Typical High $2,570.40 | Facility | None | $977.24 | $1,445.44 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,659.59 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $1,000.00 Typical High $1,584.89 | Professional | None | $66.07 | $1,000.00 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $2,344.23 | Professional | None | $933.25 | $1,479.11 | $2,344.23 |
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 $467.74 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $467.74 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $186.21 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $707.95 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $141.25 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $93.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $660.69 | $912.01 | $912.01 |
Where South Carolina sits
The same service costs 4.6 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· 44th of 51
$1,175
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.