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 $2,630.27 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,630.27 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,630.27 | $2,630.27 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $3,801.89 | Professional | None | $1,698.24 | $2,089.30 | $3,801.89 |
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 $2,290.87 Median $2,630.27 Typical High $4,466.84 | Professional | None | $2,290.87 | $2,630.27 | $4,466.84 |
Medcost Setting Facility Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $5,248.07 | Facility | None | $1,905.46 | $2,630.27 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $3,235.94 | Professional | None | $2,137.96 | $2,691.53 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $1,949.84 Typical High $3,162.28 | Professional | None | $169.82 | $1,949.84 | $3,162.28 |
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 $1,905.46 Median $2,951.21 Typical High $4,786.30 | Professional | None | $1,905.46 | $2,951.21 | $4,786.30 |
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 $954.99 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $954.99 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $380.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,412.54 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $281.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $190.55 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,862.09 | $1,862.09 |
Where South Carolina sits
The same service costs 5.1 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· 45th of 51
$2,089
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.