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 $524.81 Median $9,120.11 Typical High $21,877.62 | Facility | None | $524.81 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $1,258.93 Typical High $1,698.24 | Professional | None | $436.52 | $1,258.93 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,548.13 Typical High $12,302.69 | Facility | None | $851.14 | $3,548.13 | $12,302.69 |
BCBS South Carolina Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $1,621.81 | Professional | None | $346.74 | $446.68 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,884.03 | Facility | None | $602.56 | $1,778.28 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $1,071.52 Typical High $2,290.87 | Professional | None | $398.11 | $1,071.52 | $2,290.87 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $1,000.00 Typical High $2,187.76 | Facility | None | $524.81 | $1,000.00 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,819.70 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,412.54 Typical High $2,290.87 | Professional | None | $162.18 | $1,412.54 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,023.29 Typical High $2,290.87 | Professional | None | $380.19 | $1,023.29 | $2,290.87 |
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 $239.88 Median $288.40 Typical High $831.76 | Professional | 52 · Reduced service | $239.88 | $288.40 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $114.82 Typical High $338.84 | Professional | 53 · Discontinued | $95.50 | $114.82 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $426.58 Typical High $1,258.93 | Professional | 54 · Surgery only | $354.81 | $426.58 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $85.11 Typical High $251.19 | Professional | 55 · Aftercare only | $72.44 | $85.11 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $57.54 Typical High $169.82 | Professional | 56 · Pre-op care only | $47.86 | $57.54 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $398.11 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $331.13 | $398.11 | $1,174.90 |
Where South Carolina sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 32nd of 51
$1,349
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.