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 $1,698.24 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,698.24 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,698.24 | $1,698.24 |
BCBS South Carolina Setting Facility Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $10,471.29 | Facility | None | $10,471.29 | $10,471.29 | $10,471.29 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,621.81 | $2,398.83 |
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 $1,445.44 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,445.44 | $1,621.81 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $3,388.44 | Facility | None | $1,202.26 | $1,698.24 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $2,041.74 | Professional | None | $1,548.82 | $1,778.28 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $1,174.90 Typical High $2,041.74 | Professional | None | $109.65 | $1,174.90 | $2,041.74 |
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 $1,202.26 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,202.26 | $1,862.09 | $3,019.95 |
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 $602.56 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $602.56 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $239.88 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $912.01 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $181.97 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $120.23 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $851.14 | $1,174.90 | $1,174.90 |
Where South Carolina sits
The same service costs 5.5 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· 43rd of 51
$1,318
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.