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 $660.69 Median $10,964.78 Typical High $21,877.62 | Facility | None | $660.69 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $660.69 | Professional | None | $467.74 | $660.69 | $660.69 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $4,365.16 Typical High $13,182.57 | Facility | None | $1,047.13 | $4,365.16 | $13,182.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $891.25 | Professional | None | $457.09 | $537.03 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,511.89 Typical High $3,548.13 | Facility | None | $630.96 | $2,511.89 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $1,096.48 | Professional | None | $501.19 | $588.84 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $912.01 Typical High $2,089.30 | Facility | None | $478.63 | $912.01 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,148.15 | Professional | None | $575.44 | $724.44 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $562.34 Typical High $870.96 | Professional | None | $56.23 | $562.34 | $870.96 |
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 $457.09 Median $645.65 Typical High $1,174.90 | Professional | None | $457.09 | $645.65 | $1,174.90 |
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 $234.42 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $234.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $93.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $354.81 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $70.79 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $46.77 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $331.13 | $457.09 | $457.09 |
Where South Carolina sits
The same service costs 5.4 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· 44th of 51
$661
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.