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 $457.09 Median $9,120.11 Typical High $21,877.62 | Facility | None | $457.09 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $1,479.11 Typical High $1,995.26 | Professional | None | $416.87 | $1,479.11 | $1,995.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $10,232.93 | Facility | None | $851.14 | $2,818.38 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $1,479.11 | Professional | None | $302.00 | $389.05 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,511.89 | Facility | None | $602.56 | $1,778.28 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $933.25 Typical High $2,691.53 | Professional | None | $338.84 | $933.25 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $1,000.00 Typical High $2,187.76 | Facility | None | $457.09 | $1,000.00 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,548.82 | $1,905.46 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,659.59 Typical High $2,630.27 | Professional | None | $162.18 | $1,659.59 | $2,630.27 |
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 $331.13 Median $1,023.29 Typical High $2,454.71 | Professional | None | $331.13 | $1,023.29 | $2,454.71 |
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 $208.93 Median $245.47 Typical High $1,000.00 | Professional | 52 · Reduced service | $208.93 | $245.47 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $100.00 Typical High $398.11 | Professional | 53 · Discontinued | $83.18 | $100.00 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $371.54 Typical High $1,479.11 | Professional | 54 · Surgery only | $309.03 | $371.54 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $74.13 Typical High $295.12 | Professional | 55 · Aftercare only | $61.66 | $74.13 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $50.12 Typical High $199.53 | Professional | 56 · Pre-op care only | $41.69 | $50.12 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $346.74 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $288.40 | $346.74 | $1,380.38 |
Where South Carolina sits
The same service costs 5.8 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· 25th of 51
$1,514
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.